Penile Squamous Cell Carcinoma Following Childhood Hypospadias Repair – A Case for Long Term Surveillance — ASN Events
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  3. Penile Squamous Cell Carcinoma Following Childhood Hypospadias Repair – A Case for Long Term Surveillance

Penile Squamous Cell Carcinoma Following Childhood Hypospadias Repair – A Case for Long Term Surveillance (#174)

Brenda BN Ngo 1 2 , Alexander AN Ngoo 1 , Jodi JH Hirst 1 , David DW Wong 3 , David DW Winkle 1
  1. Urology, Mater Hospital Brisbane, Brisbane, QLD, Australia
  2. Dermatology, Mater Hospital Brisbane, Brisbane, QLD, Australia
  3. Anatomical Pathology, Mater Hospital Brisbane, Brisbane, QLD, Australia

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. 

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  2. Talab SS, Cambareri GM, Hanna MK. Outcome of surgical management of urethral stricture following hypospadias repair. Journal of Pediatric Urology. 2019.
  3. DeRosa R, Stackhouse DA, McMann LP, Sterbis JR. Penile Squamous Cell Carcinoma After a Childhood Hypospadias Repair With Bladder Mucosa Graft. Urology. 2015;85(6):1471-3.
  4. Hoag CC, Gotto GT, Morrison KB, Coleman GU, MacNeily AE. Long-term functional outcome and satisfaction of patients with hypospadias repaired in childhood. Canadian Urological Association Journal. 2013;2(1):23.