Penile tumors: their management by Mohs micrographic surgery

Penile tumors represent a difficult group of neoplasms requiring effective and curative treatment while minimizing tissue loss to prevent cosmetic and functional deformity. Over the past 6 years, we have treated 20 patients with penile cancer utilizing the fresh tissue technique of Mohs micrographic surgery. Tumors were excised with an average of 2.25 stages. Most defects (80%) were allowed to heal by second intention. Since surgery, four patients have developed metastatic disease in their regional lymphatic system, and one patient has died from metastatic spread. One patient has developed local recurrence. Micrographic surgery is a very useful treatment modality for patients with penile tumors. Patients with SCC of the penis should be considered for elective regional lymph node biopsy and/or dissection in conjunction with micrographically controlled excision of the primary tumor.