Pre-cancerous penile lesions

A heterogeneous group of abnormalities and pre-cancerous lesions affect the penis. European Association of Urology (EAU) guidelines on penile cancer report three categories of pre-malignant lesion, each with a different probability of developing into squamous cell carcinoma(SCC) of the penis: lesions sporadically associated with SCC of the penis (cutaneous horn of the penis and Bowenoid papulosis); lesions at intermediate risk of progression to SCC (balanitis xerotica obliterans); and lesions at high risk of developing into SCC of the penis (penile intraepithelial neoplasia occurring as Bowen's disease or erythroplasia of Queyrat). Microscopically, precursor neoplastic lesions are squamous hyperplasia (SH), low-grade squamous intraepithelial lesions (LSILs) and high-grade squamous intraepithelial lesions (HSI s). In this article, a practical approach to the diagnosis and treatment of pre-invasive lesions is discussed. © Touch Briefings 2010.