Organ-sparing partial glansectomy: an alternative surgical management for invasive penile carcinoma-case report.

BACKGROUND

Penile cancer is a rare malignancy treated via various surgical techniques guided by disease stage and grade with current guidelines suggesting partial or total penectomy for those with pT2 or greater. We report a case of a patient with pT2 squamous cell carcinoma (SCC) of the penis who underwent circumcision with left partial-glansectomy and en bloc resection of preputial mass with good oncological control while providing good urinary and sexual function.

CASE DESCRIPTION: An 82-year-old male presented to the clinic due to a mass that doubled in size in an 8-month timeframe. Treatment options were discussed with the patient including the risks and benefits of each electing wide-excision in glans-sparing fashion, possible partial penectomy. Given the possibility of low-grade verrucous carcinoma upon intraoperative exploration, ultimately, circumcision with left partial-glansectomy and en bloc resection of preputial mass was performed guided with intraoperative negative frozen sections. Patient's surgery and post-operative course were uncomplicated, followed with serial exams, and cross-sectional images showing no recurrence or metastasis.

CONCLUSIONS

Careful case selection with close postoperative follow-up monitoring for local recurrences, such as in this case, can allow patients to elect for organ-sparing partial glansectomy-when complete resection is feasible-as an acceptable option for oncological control in patients with pT2 penile cancer while providing good urinary and sexual function.