Microscopic image (photomicrograph) of invasive squamous cell carcinoma on penis of a man with genital warts (condylomas) related to HPV (human papillomavirus). (Source: Shutterstock)
Penile carcinoma is a malignant disease of the penis. It usually only occurs from the age of 60. In around 95 percent of cases it involves a degeneration of the bulbous head (glans) of the penis, the foreskin of the penis, or the mucous membrane of the urethra (squamous cell carcinoma). Penis cancer accounts for about one percent of all malignant cancers – there are 0.4 new diseases per 100,000 people per year.
Penis cancer is histologically (i.e. the tissue type) a cornified, usually well differentiated squamous cell carcinoma. One of the causes has been identified as certain types of human papilloma viruses (HPV 16 and 18), and also benign inflammatory precursor lesions and Lichen sclerosis and Lichen planus can develop in a squamous cell carcinoma. Another etiological factor for the development of penile cancer is poor hygiene, as chronic inflammatory changes in the glans and foreskin of the penis can occur.
Redness, itching, nodules on the glans or at the transition to the penile shaft, are evidence of a pathological change of the penis. There can be bleeding on contact with the affected area and a swelling of the inguinal lymph nodes. Penile carcinomas are usually not painful. Difficulties with urinating, oedema of the entire penis, and hardening of the large lymph nodes can be felt which are also symptomatic of penis cancer.
A reliable diagnosis can only be done by taking a biopsy. It is always important to make a differential diagnostic in order to eliminate other possibilities such as Bowen’s disease, Erythroplasia or Queyrat etc. Because some symptoms are similar to other conditions, it is safest to take a tissue sample of the tumour and the swollen lymph nodes.