Case of progression of penile cutaneous horn to squamous cell carcinoma.
A 43-year-old male patient presented to the Department of Urology with a 6-month history of a progressive growth in the glans penis. Since the lesion was painless, the patient did not seek any medical help. However, the rapid growth of the lesion prevented the patient from any sexual intercourse. Examination showed a horn-like keratinised lesion in the glans penis with no inguinal lymphadenopathy.
The patient score on ‘The International Index of Erectile Function 5 (IIEF-5)’ questionnaire was 18 (mild). At first a surgical excision of the lesion was done because the patient was reluctant to undergo a partial penectomy (surgical removal of a part of the penis). Histopathological analysis of the biopsied lesion showed extreme hyperkeratosis, dyskeratosis and epithelial hyperplasia.
The patient had an uneventful postoperative recovery. The first follow-up was after 39 days of surgery and the patient presented with a painful swelling over the glans penis with purulent discharge of the urethra. Examination showed that the patient had a 5 m nodular lesion on distal aspect of the shaft of the penis. Moreover, the penis was stiff. A pelvic magnetic resonance imaging was done which showed an unclear boundary that measured 0.6 cm in diameter. The lesion was biopsied and histopathology findings were consistent with the diagnosis of squamous cell carcinoma.
The patient finally consented to partial penectomy. Histopathology showed squamous atypia and differentiated squamous cell carcinoma. At 6-month follow-up the patient was able to urinate while standing with an IIEF-5 score of 15.
References
Progression of penile cutaneous horn to squamous cell carcinoma: A case report https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4114708/
