Penile cancer

Question 1

Features and prognosis (4)

Answer 1

rare
95% are SCC
often have long preceeding Hx of dysuria, dyspareunia, balanoposthitis and phimosis
poor prognosis w/o Rx.

Question 2

Premalignant conditions (3)

Answer 2

erythroplasia of queryat’s (bowen’s disease)
balanitis xerotica obliterans
bowenoid papulosis (cutaneous horn)

Question 3

Features of erythroplasia of Queryat’s (6)

Answer 3

CIS
red and velvety
on glans of uncircumcised men
driven by HPV 16
may progress to SCC
All cases need a biopsy

Question 4

features of balanitis xerotica obliterans (3)

Answer 4

lichen sclerosus of penis
atrophic white patches
may respond to topical steroids.

Question 5

Features of Bowenoid papulosis (4)

Answer 5

Warty
pigmented, smooth and can coalesce
must Rx as 1/3 have SCC underneath
Rx w. topical 5-FU and imiquimod, surgery and cryotherapy

Question 6

factors assoc. w. penile ca. (2)

Answer 6

HPV 16

lichen sclerosus

Question 7

RFs for penile ca. (11)

Answer 7

UNCIRCUMCISED
phimosis
smoking
poor hygiene
multiple sexual partners
lichen sclerosus, lichen planus, squamous hyperplasia
HPV
HIV
iatrogenic immunosuppression
photochemotherapy
inflammation, irritation and scarring

Question 8

Rx of early penile ca.

Answer 8

radiotherapy and irradium wires

Question 9

Rx of advanced penile ca. (4)

Answer 9

glansectomy
circumcision
penile amputation
LN dissection