Background: Hypospadias is the most common congenital abnormality of infant males characterized by the urethra opening in an abnormal position on the ventral penis. Up to 10% of those who undergo childhood surgical repair develop complications in adulthood such as meatal stenosis. This results in retained urine and predisposition to recurrent balanitis and urinary tract infections. We report a case of penile squamous cell carcinoma (SCC) following childhood hypospadias repair.
Methods: Written consent was obtained from the patient.
Results: A 46-year-old man presented with a 20 x 20mm erythematous, firm, irregular skin lesion on the ventral surface of his distal penile shaft. His past medical history was significant for proximal hypospadias repair and circumcision at 4 years of age. At age 26, the patient had developed a meatal stenosis resulting in chronic obstructive voiding symptoms and recurrent urinary tract infections. The patient denied any history of tobacco use, sexually transmitted infections (STIs) or psoralen-ultraviolet photochemotherapy.
The lesion was excised and histopathology revealed moderately differentiated keratinising SCC with associated balanitis xerotica obliterans. The lesion extended from penile skin to the urethra. PET-CT Staging and lymph node biopsies excluded locoregional or metastatic spread. The patient has ongoing multi-disciplinary surveillance and has been recurrence free for 24 months.
Conclusion: This is the second reported case of penile SCC following childhood hypospadias repair and the first ever reported in Australia. Hypospadias is a rare aetiological risk factor for penile SCC and our case highlights the need for multidisciplinary care for penile cancer patients.