Pathway from lichen sclerosus to squamous cell carcinoma of the penis: the oncologist's perspective

Male genital lichen sclerosus (LS) is a chronic inflammatory disorder with malignant potential, transforming into penile squamous cell carcinoma (SCC) in up to 30 % of cases. We report a 59-year-old man diagnosed with LS in 2008 after circumcision, without follow-up. Sixteen years later, he developed a suspicious induration of the balanopreputial sulcus. Partial penectomy and lymphadenectomy revealed a pT2N3 SCC with adjacent LS. Rapid local recurrence required total penile amputation, followed by adjuvant chemotherapy. This case underscores the strong LS-SCC association and the need for early recognition, continuous surveillance, and timely multidisciplinary management to prevent delayed diagnosis and radical surgery.