Squamous Cell Carcinoma of the Penis

Key Points
Rare malignancy that affects the penis, typically the glans and inner foreskin
Exact cause is unknown, but its formation is associated with various factors including HPV
Consists of small plaques which are red in color and may have varying texture

Squamous cell carcinoma (SCC) of the penis is a rare cancerous condition which affects the penis, typically developing on the glans or inner foreskin. The condition consists of small plaques which are red in color forming in the affected area. Texture of lesions may be velvety, smooth, scaly or warty, and the condition may be accompanied by inflammation, crusting, scaling, itching, pain, redness, ulceration, and bleeding. In cases which have gone untreated, discharge from the penis and difficulty with urination and the foreskin may occur.

The exact cause of squamous cell carcinoma of the penis is unknown, but its formation is associated with various other condition, such as chronic HPV infection or skin disorder (lichen sclerosus and planus), irritation or injury to the penis, and suppression of the immune system via disease or medication. Approximately 30% of men who develop the condition develop invasive SCC of the penis. While it may occur in any age group, men over fifty, especially those who are uncircumcised, are more likely to develop the condition.

Differential Diagnosis (Other conditions with similar appearance)
Balanitis Circumscripta Plasmacellularis
Contact Dermatitis, Irritant
Balanitis Xerotica Obliterans
Drug-Induced Bullous Disorders
Balanoposthitis
Psoriasis, Plaque
Candidiasis, Mucosal
Squamous Cell Carcinoma
Contact Dermatitis, Allergic

Diagnosis
Key Points
Diagnosis based on skin biopsy of the affected area
Other tests may be performed to rule out other conditions

Squamous cell carcinoma of the penis is typically diagnosed based on a skin Biopsy of the affected area. Other tests including bacterial and/or viral cultures may be performed to rule out similar appearing conditions.

Treatment
Maintaining hygiene is important
Various therapies are available for use in treatment
The condition may recur in a small number of affected persons

Once diagnosed, squamous cell carcinoma of the penis may be treated with various therapies. Maintaining hygiene of the genitals is very important. Treatment used may include topical therapies such as 5-fluorouracil or Imiquimod creams, cryotherapy, curettage and cautery, laser therapies, photodynamic and radiotherapies, surgical excision, and interferon alpha. Severe cases or cases which recur may require Moh's micrographic surgery. In a small number of affected persons (up to 10%) the condition may recur. Additionally, partners of affected persons should be examined for complications resulting from HPV infection.