This document discusses tumors of the penis, including both benign and malignant types. It begins with the normal anatomy and histology of the penis. The main tumors discussed are condyloma acuminatum and Peyronie's disease as benign tumors. Malignant tumors include penile intraepithelial neoplasia (PIN), which can be differentiated or undifferentiated, and invasive squamous cell carcinoma. Risk factors for squamous cell carcinoma include HPV infection, poor hygiene, smoking, and phimosis. Staging and treatment options ranging from circumcision to hemipelvectomy are provided depending on the stage and type of tumor.
9. BENIGN TUMORS
Condyloma Acuminatum
• Benign sexually transmitted wart caused by human
papillomavirus (HPV)
• Occur on any moist mucocutaneous surface of the external
genitals in male or female
• Cause : “Lowrisk” HPV serotypes
(HPV 6 and, less frequently, HPV 11)
11. BENIGN TUMORS
Peyronie Disease
• Deposition of collagen in the
connective tissue between the
corpora cavernosa and the tunica
albuginea
• Microvascular trauma and
subsequent organizing sclerosing
chronic inflammation leads to
fibrosis
14. DIFFERENTIATED PeIN
• Non – HPV related
• Associated with balanitis xerotica obliterans
• Occurs on the foreskin of older patients
• Retains a degree of squamous maturation
15. UNDIFFERENTIATED PeIN
• Manifest clinically as two distinct lesions
• Bowen disease
• Bowenoid papulosis
• Both are associated with high-risk HPV
• Most commonly HPV 16
16. DIFFERENCE
FEATURES BOWEN DISEASE BOWENOID PAPULOSIS
Age Older Young adults
Number of Lesion Solitary Multiple
Gross feature Thickened, gray-white, opaque plaque Reddish brown papule
Microscopic
feature
Dysplastic squamous cells containing
large hyperchromatic irregular nuclei
and lacking orderly maturation
Same as Bowen disease
Behaviour 10% gives rise to infiltrating
squamous cell carcinoma
Never develops into invasive
carcinoma and usually regresses
spontaneously
Association with
HPV
HPV 16 HPV 16
18. INVASIVE SQUAMOUS CELL CARCINOMA
• Age : 40 to 70 years
• Risk factors :
• Poor genital hygiene
• High risk HPV (HPV 16, HPV 18)
• Cigarette smoking
• Chronic inflammation (Balanitis xerotica obliterans)
19. PROTECTIVE FACTORS
Circumcision
• Reduces exposure to
carcinogens that gets
concentrated in smegma
• Decreases the infections
with potentially
oncogenic types of HPV
28. STAGING
T1 - SUBEPITHELIAL CONNECTIVE
TISSUE
Tis – Carcinoma In situ
Ta – Non Invasive Carcinoma
T2 – CORPUS SPONGIOSUM ±
URETHRA
T3 – CORPUS CAVERNOSUM ±
URETHRA
T4 – OTHER ADJACENT
STRUCTURES
34. T1, T2, T3
• Partial Penectomy – 3 cm stump left
• Total Penectomy – No stump left
• Emasculation – Penis along with scrotum and testicles removed (Also for T4)
