Although in the western world penile cancer accounts for less than 1% of all male malignancies, it represents a significant health problem in developing countries, where it accounts for 10-20% of all malignancies in men. In 95% of cases penile malignancies are squamosus cell carcinomas. Glans is the most common location (48%), followed by prepuce (21%), glans and prepuce (9%), coronal sulcus (6%), and shaft (< 2%). The clinical presentation of penile squamous cell carcinoma is variable and may range from an area of induration or erythema to a non-healing ulcer or a warty exophytic growth. The differential diagnosis includes precancerous lesions and a variety of inflammatory conditions. Diagnosis is confirmed with biopsy. Imaging is indicated for staging purposes.
Among the remaining 5% of primary penile malignancies sarcomas are the most frequent, followed by melanoma, basal cell carcinoma, and lymphoma. Kaposi’s sarcoma increased in frequency with the onset of AIDS.
Penile hemangioma is the most frequent benign tumor of the penis. Giant cavernous hemangioma may involve the entire glans and a variable portion of the corpora cavernosa, scrotum and perineum. Metastatic cancer to the penis usually occurs in patients with a known malignancy in an advanced stage to prostate, bladder, lung, malignant melanoma, colon and kidney.
