Dr. med. Dirk Manski

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Verrucous Carcinoma of the Penis


Definition:

Verrucous penile carcinoma (Buschke-Löwenstein tumor) is a variant of well-differentiated penile carcinoma with local aggressive exophytic papillary lesions.

Epidemiology:

Verrucous penile carcinoma is a rare disease.

Etiology:

Lichen sclerosus, balanitis, and phimosis are risk factors; see section penile cancer. Although verrucous carcinoma of the penis has macroscopic similarities with condylomata acuminata, the pathogenesis of verrucous carcinoma of the penis is not associated with HPV.

Pathology:

Verrucous carcinoma consists of well-differentiated squamous epithelium without significant cellular atypia or invasion of subepithelial connective tissue (pTa penile carcinoma). Lymph node metastases are seldom possible; this argues for de-differentiation to classic penile carcinoma.

Signs and symptoms:

Cauliflower-like penile tumor, which may displace and destroy local structures by compression [fig. Verrucous carcinoma of the penis].

Diagnosis and Treatment:

Perform an organ-preserving complete excision of the tumor with a minimal surgical margin if verrucous penile carcinoma is anticipated. Abundant and deep biopsies are necessary to differentiate from invasive penile carcinoma. Close follow-up is required. Invasive lymph node staging is necessary for those with persisting inguinal lymphadenopathy.






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References

O.W. Hakenberg and E. Compérat and S. Minhas and A. Necchi and C. Protzel and N. Watkin, “EAU Guidelines: Penile Cancer,” 2020. [Online]. Available: https://uroweb.org/guidelines/penile-cancer/.

D. I. Jo, S. H. Han, S. H. Kim, H. Y. Kim, H. Chung, and H. S. Kim, “Optimal treatment for penile verrucous carcinoma: a systematic literature review.,” BMC Urol., vol. 21, no. 1, p. 13, 2021.

Seixas u.a. 1994 SEIXAS, A. L. ; ORNELLAS, A. A. ; MAROTA, A. ; WISNESCKY, A. ; CAMPOS, F. ; MORAES, J. R. de: Verrucous carcinoma of the penis: retrospective analysis of 32 cases.
In: J Urol
152 (1994), Nr. 5 Pt 1, S. 1476–8; discussion 1478–9



  Deutsche Version: Verruköses Peniskarzinom