Penile Cancer in Liberia: A Case Report and Review of the Literature

Abstract

Background: Penile cancer is uncommon in Liberia with no record of its occurrence so far in the literature. Its occurrence worldwide is significantly affected by cultural or religious practices like childhood circumcision. Smoking, poor penile hygiene and inflammatory processes in the presence of smegma increase the risk of its occurrence. Objective: To review the first case of penile cancer treated in Liberia. Materials and Method: Case report. Case Presentation/Report: Our index patient is a 65-year old man referred from a peripheral centre in acute urinary retention. He also presented with a year history of progressively expanding ulcerative penile lesion affecting the glans and penile shaft. Local examination of the genitalia revealed an ulcerated lesion extending from the glans up to the mid shaft of the penis. The peno-bulbar urethra was free of induration. The external urethral meatus was infiltrated by the lesion. The scrotum and testes were normal and digital rectal examination revealed a moderately enlarged benign prostate. Bilateral inguinal lymph node enlargement was elicited. A diagnosis of advanced penile cancer with benign prostatic hyperplasia was made. The patient had partial penectomy, reconstruction of new external urethral meatus and inguinal lymphadenectomy. The specimen was histologically confirmed to be Squamous cell Carcinoma of the penis; the resection margins and lymph nodes biopsied were found to be adequate and tumor free respectively. Patient's post operative recovery was uneventful and he was discharged after a week. His follow up status after 6 months has remained satisfactory. Conclusion: Though rare, penile cancer does occur in Liberia and specialist staff with capacity for diagnosing and surgical intervention remains critical to patients' outcome. Early intervention improves the chances of better outcome; counseling is critical to prevent treated patient lapsing into depression.