Penile Squamous Cell Carcinoma Complicating Lichen Sclerosus: A Case Report

Abstract

Introduction: Penile tumors are among the rarest malignancies of the male urogenital tract. The most common histological type is squamous cell carcinoma, which is characterized by local invasion and early lymphatic spread. Treatment is often mutilating, and the disease imposes a substantial psychological burden, particularly given its genital location. Lichen sclerosus has been recognized as an important risk factor; however, it remains underdiagnosed and poorly understood, particularly among non-dermatology practitioners. Case Presentation: We report the case of a 71-year-old circumcised man with diabetes who developed a chronic hypopigmented lesion on the glans penis that progressed over 4 years into a bleeding, indurated nodule. Clinical and dermoscopic examinations revealed a circumferential tumor with underlying features of lichen sclerosus. A biopsy confirmed moderately differentiated squamous cell carcinoma arising in the setting of lichen sclerosus. Imaging demonstrated local invasion without distant metastasis. The patient underwent partial penectomy with lymph node dissection. At the 12-month follow-up, there was no evidence of recurrence or metastasis, and the patient reported improved quality of life. Conclusions: This case highlights the potential for malignant transformation in long-standing, untreated lichen sclerosus. Although often considered a benign condition, lichen sclerosus warrants early diagnosis and long-term surveillance to prevent serious complications such as penile squamous cell carcinoma.