From the Research
The most common fungating tumor of the penis is squamous cell carcinoma (SCC), accounting for approximately 95% of all penile neoplasms. This malignancy typically presents as an exophytic, fungating mass with irregular borders, often on the glans or prepuce 1. Penile SCC usually develops from precancerous lesions like penile intraepithelial neoplasia and is strongly associated with human papillomavirus (HPV) infection, particularly HPV types 16 and 18 2, 1. Other risk factors include chronic inflammation, poor hygiene, phimosis, and smoking.
Key Points
- Early detection is crucial, as treatment depends on the stage but may include surgical excision, radiation therapy, or chemotherapy 1, 3.
- Any persistent penile lesion, especially one that is fungating, ulcerating, or non-healing, should prompt immediate medical evaluation to rule out malignancy.
- The prognosis for penile SCC varies based on stage at diagnosis, with early detection significantly improving outcomes 1.
Diagnosis and Treatment
- Diagnosis of PSCC is done through clinical examination, including lymph node palpation, followed by a biopsy, which is essential for the classification 1.
- Treatment options for PSCC include surgery, chemotherapy, and radiation therapy, with surgical removal of the tumor considered the most effective, although it can lead to a severe decrease in quality of life 1.
- The 2022 WHO classification reinforces the subclassification of precursor lesions and tumors into HPV-associated and HPV-independent types, with block-type positivity of p16 immunohistochemistry being the most practical method to separate HPV-associated from HPV-independent penile SCC 3.