Advanced Penile TUmors with Bulky Disease

Some patients with penile cancer will always continue to present late. Aggressive penile SCC subtypes particularly sarcomatoid lesions can progressively cause widespread necrosis of the adjacent skin. In such cases, autoamputation of the penis results followed by widespread malignant infiltration of the subcutaneous tissue.13 If left untreated concomitant sepsis may ensue which is often fatal. Figure 7.13 illustrates a sarcomatoid SCC of the penis in a 51-year-old patient presenting after first noticing a small penile lesion 12 months previously. Extensive lesions such as these are not amenable to radiotherapy and require prompt surgical resection for palliation (Fig. 7.14). In this particular patient the presence of a large abdominal pannus allowed complete resection followed by primary closure of the defect using an abdominoplasty (Fig. 7.15). Despite postoperative chemoradiation this particular patient died after 7 months.

Fig. 7.13 Advanced sarcomatoid SCC of the penis

Fig. 7.13 Advanced sarcomatoid SCC of the penis

Fig. 7.15 Primary closure of the wound by performing an abdominoplasty
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