EtiologyCircumcision soon after birth confess almost complete immunity against carcinoma of the penis.later circum. does not seem to have d same effect.chronic balanoposthitis is known to b a contributory factor,there r different precarcinomatous states-
-leucoplakia of d glans
-long standing genital warts
-pagets disease of penis is persistent rawness of the glans lik a longstanding balinitis followed by cancer of penis.
PathologyCarcinoma of the penis may be flat and infiltrating or papillary.it can start as leukoplakia.d earliest lymphatic spread is to the inguinal and then to iliac nodes.once the growth breaches the partial barrier formed by fascial sheath of Corpora cavernosa it spreads rapidly and iliac lymph node involvement is common
C/f-forty percent patients are under 40 years of age.
-initially discomfort and light discharge
-foul bloody discharge and little or on pain.
-sixty percent have inguinal lymph node enlargement when they present
-prepuce is non retractile
-untreated the whole glans may b replaced by a fungating offensive mass.
Treatment-radiotherapy is effective (60-70% survival at 5years) if the growth is small.circumcision precedes treatment which may b delivered by implanted radioactive tantalum wires,external beam radiation or by means of radio.mould applicator applied to penis
-surgery is needed if there is infiltration of shaft n when radiotherapy fails.partial amputation used for distal growths.when an advanced infijtrating or anaplastic lesion present total ampu is necessary.
-block dissection of enlarged lymph nodes.