Penile Cancer Diagnostic Workup

Authored by Asif Muneer, published on 2026-11-03 23:17:39.0

Diagnostic Work-Up of Penile Cancer
- Assessment of the Primary Tumour
  
  Clinical assessment, including size, morphology, and relationship with adjacent structures [III, A]. In cases of uncertainty, MRI or US combined with an intracavernosal injection of prostaglandin E1 can be useful [III, B].
  - Assessment of Regional LNs
    
    Impalpable inguinal LNs: US and FNAC [IV, A]. Palpable inguinal LNs: US and percutaneous FNAC or biopsy, with repeat FNAC or excisional biopsy of the node advised for a negative biopsy and clinically suspicious nodes [III, A].
    - Assessment of Distant Metastasis
      
      CT of the chest, abdomen, and pelvis [III, A]. MRI or CT fusion PET can be used in patients with high-risk disease [IV, B].
      - Staging, Pathology and Risk Group Classification
        
        Staging should follow WHO 2022, UICC eighth edition, or AJCC eighth edition [I, A]. Pathological assessment should include HPV status, histological grade, and tumour type [III, A]. Grading should follow the WHO system [IV, A].

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