Excisional biopsy and primary inguinal radiotherapy as definitive treatment for ulcerative invasive squamous cell carcinoma of the penis

Abstract

Penile cancer is a rare malignancy worldwide with a higher incidence in developing countries. Patients may present early with pe­nile ulcer due to disfigurement, recurrent infections or discomfort. When the lesion is confined to the skin of the root of the penis, excisional biopsy of the ulcer may be a definitive surgical treatment. We present a 67-year-old man with a malignant penile ulcer at the ventral aspect of the root of penis who underwent excisional biopsy with wide margin and closure of the wound defect with a scrotal advancement flap. The histology revealed well-differentiated squamous cell carcinoma with free surgical margin. He developed left inguinal lymphadenopathy which resolved after external beam radiation of the left groin. He defaulted and subse­quently developed right groin recurrence after 3 years which was excised and covered with an advancement flap.