Background

Question 1

What is the estimated annual incidence of penile cancer in the United States? What % of male cancers does this represent?

Answer 1

There are ∼2,000 new cases/yr of penile cancer in the United States, representing <1% of male cancers. In developing countries, it can account for up to 10% of all male cancers.

Question 2

What are the major risk factors for developing penile cancer?

Answer 2

Risk factors for penile cancer:

Lack of circumcision
Phimosis
HPV infection (45%–80% of cases are related)
HIV infection
Others risk factors include: chronic inflammation, poor hygiene, trauma, lichen sclerosus, smoking, and PUVA therapy.

Question 3

What is penile intraepithelial neoplasia (PeIN)?

Answer 3

PeIN is a premalignant condition at high risk of developing into SCC of the penis and includes bowenoid papulosis, erythroplasia of Queyrat (glans and prepuce), and Bowen Dz (penile shaft).

Question 4

What are the 2 most common anatomic locations for penile cancer?

Answer 4

The glans and prepuce are the 2 most common locations for penile cancer. Less common locations include the coronal sulcus and the shaft. Lesions can appear as a mass, ulceration, or inflammation.

Question 5

What is the lymphatic drainage for penile cancers?

Answer 5

Superficial inguinal nodes → deep inguinal nodes → external iliac nodes → other pelvic nodes

Question 6

What % of men with penile cancer and palpable inguinal nodes have pathologically involved inguinal nodes?

Answer 6

Overall, ∼58% of palpable inguinal nodes in pts with penile cancer are pathologically involved.

Question 7

What is the likelihood of occult nodal Dz in men who are cN0?

Answer 7

The likelihood of occult nodal involvement depends on the tumor stage, grade, and presence of LVI. It is 4%–14% for Tis, Ta, or T1 lesions and 60% for T2 lesions.

Question 8

What % of men with penile cancer present with DM?

Answer 8

1%–10% present with DM.

Question 9

What are the most common sites for DM in penile cancer?

Answer 9

Lung, liver, and bone are the most common sites for DM in penile cancer.

Question 10

What is the most common histology in penile cancer?

Answer 10

SCC accounts for 95% of penile malignancies. Other histologic subtypes include sarcoma, urethral tumors, lymphoma, and basal cell carcinoma.