This document discusses carcinoma of the penis (CA penis) in young men. CA penis is rare in men under 45, with an incidence of less than 1 per 100,000 men. Early detection is difficult. Risk factors include phimosis, lack of circumcision, multiple sexual partners, smoking, poor hygiene, HPV infection, and BXO. CA penis typically begins as a small lesion that can gradually extend and involve the glans or corpora. Lesions over 5cm or involving over 75% of the shaft indicate potential metastasis. Patients often delay seeking medical care for over a year due to guilt, fear, ignorance or neglect. Younger men are more likely to have nodal involvement at diagnosis. Surgical

1. Discussion :
CA penis in men <45 is rare.
 an incidence of up 0.8/100,000.
 very few cases recorded in young adult till now.
 Detection of CA in early phase is difficult task.

2. Discussion:
Many risk factors have been identified including:
 Phiomosis.
 Lack of circumcision.
 Multiple sexual partner.
 BXO
 Smoking
 Poor Hygenic standard.
 HPV infection

3. Discussion :
 Ca penis begins with small lesion.
 Gradually extends to involve the glans to carpora.
 Lesion may be papillary & exophytic, flat or
ulcerative.
 Lesion >5cm and 75% shaft involvent indicate
metastatic.

4. Discussion:
 50% patients delayed medical care >1 yr.
 Due to : guilt, fear, ignorance and personal neglect.
 younger men were more likely to have nodal
involvement at time of diagnosis.

5. Discussion:
 Surgical removal of primary tumor is still gold
standard.
 >4cm ,grade 3 lesion ,invading deep to glans ,urethra
partial or total penectomy should be considered.
 In our case partial penectomy was considered due to
involvement of glans and mid shaft.

6. Discussion :
 Partial penectomy should be considered the standard for
high-grade primary penile tumors.
 Benefit of partial penectomy:
I. adequate penile stump
II. negative margins are obtained.

7. Discussion :
As this case is unique due to:
Young Age( 32yrs)
Involving glans and mid shaft.
Nodal involvement.
No H/o any pre malignant lesion.

8. Summary:
Early advancement can be prevented by:
 Early infant Circumcision
 Hygiene measures
 Early diagnosis
 Education
 stop Smoking

9. Refrences:
 O'Kelly JA, Browne E, Daly P, Keane J, Shah N, Shilling C, Cullen IM. Penile
cancer in younger men—A more aggressive disease?. InUrologic Oncology:
Seminars and Original Investigations 2023 Jul 1.
 Vieira CB, Feitoza L, Pinho J, Teixeira-Júnior A, Lages J, Calixto J, Coelho R,
Nogueira L, Cunha I, Soares F, Silva GE. Profile of patients with penile cancer in
the region with the highest worldwide incidence. Scientific reports. 2020 Feb
19;10(1):2965.
 NCCN Guidelines Version 1.2023 Penile Cancer
 AUA Guide line for CA penis.
 EUA Guide line for CA penis.
 Campbell -walsh Urolgy