Management of Penile Cancer in Grodno Region; A Case Series

Penile carcinoma is a rare malignancy with a varied presentation and pathology, typically affecting men in their sixth and seventh decades of life. This paper presents a retrospective case series of 22 patients (aged 35–90 years) treated for malignant neoplasm of the penis (ICD 10, C60) at the Department of Oncology in the Grodno regional hospital, Belarus, between 2020 and 2024. The majority of tumors were located on the glans penis (14 patients), followed by overlapping lesions (5 patients), the shaft (2 patients), and the prepuce (1 patient). Comorbidities were highly prevalent, affecting 19 out of 22 patients. The most frequent histological diagnosis was large cell keratinizing squamous cell carcinoma (17 patients), with the remainder being non-keratinizing SCC. Clinical presentation was diverse, including penile swelling and pain, phimosis, ulcerated wounds, and inguinal lymphadenopathy. Lymph node metastasis was observed in 10 patients (45.45%), including bilateral inguinal and obturator involvement. Treatment primarily involved surgery, with total penectomy (9 patients) and partial penectomy (7 patients) being the most common procedures, in addition to lymph node dissection, chemotherapy, and radiotherapy. Three illustrative cases highlight the diagnostic challenge, including one mimicking Peyronie's disease and another presenting with a paraneoplastic syndrome. The overall survival rate in this series was 50%, with 11 patients deceased by January 2025, underscoring that locoregional and metastatic disease remain fatal with late diagnosis and high mortality. Keywords: Penile cancer, Squamous cell carcinoma, Penectomy, Lymphadenectomy, Metastasis.