Role of radiotherapy in the treatment of locally advanced penile cancer

Penile cancer is a rare but aggressive tumor, most commonly squamous cell carcinoma. Treatment modalities depend on the stage of the disease, but the backbone of treatment is surgical resection of the primary tumor and regional lymph nodes with the use of neoadjuvant/adjuvant chemotherapy and radiotherapy. Our case report is about a 59-year-old patient which was presented with bilateral inguinal lymphadenitis, scrotal and penile edema. A biopsy of the change in the penis confirmed squamous cell carcinoma. Partial amputation of the penis and an excisional biopsy of the inguinal lymph nodes was performed, which confirmed the metastasis to the lymph nodes. Diagnostic imaging revealed bilateral enlarged inguinal lymph nodes which were later surgically removed. Postoperative CT scan showed three suspected lung metastases. The patient was then treated with polychemotherapy. Follow-up CT scan showed complete regression of metastatic changes in the lungs but also showed local recurrence in the area of the penile root. Radiotherapy with concomitant administration of cisplatin was conducted. Penile cancer is an aggressive disease that can be cured at an early stage if adequate treatment is applied. We highlight the importance of a multimodal and multidisciplinary approach consisting of polychemotherapy, surgical treatment, and radiotherapy.