What are the early symptoms of penile tumors?

Common symptoms of penile tumors include the presence of nodules and lumps on the coronal sulcus of the glans penis and the mucosa of the inner foreskin, which gradually increase in size. Some may even show symptoms of plaque ulceration, so correct treatment is essential.

1. Clinical manifestations

Penile cancer often starts on the mucous membrane of the glans penis, coronal sulcus and inner foreskin. For patients with phimosis, the early stage of the lesion is not easy to be found. Nodules or lumps can be felt in the foreskin, which gradually increase in size and can penetrate the foreskin to expose the cancer. Purulent or bloody secretions often flow out of the foreskin opening. Patients whose foreskin can be everted to expose the glans penis will show papules, papillary or flat protrusions, warts or cauliflower-like plaques, ulcers at the lesion site. The lesion gradually increases in size and is often accompanied by foul-smelling secretions on the surface. Penile cancer rarely occurs in the body of the penis. Due to the associated infection, patients with penile cancer often have unilateral or bilateral inguinal lymph node enlargement. About 50% of patients with enlarged lymph nodes are pathologically confirmed to have lymph node metastasis.

2. Clinical diagnosis

It is not difficult to diagnose typical penile cancer patients through clinical examination. To confirm the disease, it is necessary to take the lesion tissue for pathological examination. The most common types under the microscope are keratinizing and moderately differentiated squamous cell carcinoma. There are 7 subtypes of penile squamous cell carcinoma: basaloid carcinoma, hygroma carcinoma, papillary carcinoma, sarcomatoid carcinoma, mixed carcinoma and adenosquamous carcinoma. Other types of penile cancer are rare.

3. Treatment

Surgical removal of the lesion is the main and most effective treatment method. Circumcision, partial penectomy and total penectomy plus urethro-pudendostomy can be selected according to the location, size and stage of the lesion. The excision range of partial penectomy should be at least 2 cm of normal tissue away from the edge of the tumor. Because it is often accompanied by infection, it is best to take anti-inflammatory treatment for one week before surgery, including local anti-inflammatory treatment of the lesion. For patients without enlarged inguinal lymph nodes, routine inguinal lymph node dissection is not recommended at present. If biopsy confirms metastasis of the inguinal lymph nodes, inguinal lymph node resection or dissection can be performed. Combined radiotherapy can be considered after surgery.

Patients with advanced penile cancer and distant metastasis should consider chemotherapy. Commonly used chemotherapy drugs include bleomycin, 5-fluorouracil, cyclophosphamide, etc. Chemotherapy can also be combined with surgery and radiotherapy.