Neglected Case of Penile Carcinoma: A Case Report

Neglected Case of Penile Carcinoma: A Case Report | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Neglected Case of Penile Carcinoma: A Case Report varsha yeshwant Lamture, yeshwant lamture This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8102882/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Penile carcinoma, most commonly squamous cell carcinoma, is a rare but aggressive malignancy, with prognosis improving significantly when diagnosed early. Social stigma, limited awareness, and poor access to healthcare often result in delayed presentation, negatively affecting outcomes. We report a middle-aged man from a remote tribal area who presented with an eight-month history of a painless penile nodule that gradually progressed to a large ulceroproliferative lesion involving the glans and shaft, associated with bilateral inguinal lymphadenopathy. Penectomy procedure was done after Histopathological examination which showed squamous cell carcinoma. He was advised follow after after 1month and later 3month subsequently. Surgery Penile carcinoma squamous cell carcinoma penectomy late presentation Figures Figure 1 INTRODUCTION Penile carcinoma is a rare malignancy, representing less than 1% of all male cancers globally, but it carries significant morbidity and mortality when diagnosed at an advanced stage. The majority of cases are histologically squamous cell carcinoma, which arises from the epithelial lining of the glans, foreskin, or shaft. Multiple risk factors have been implicated in its pathogenesis, including poor genital hygiene, phimosis, chronic balanitis, smoking, genital viral infection due to human papilloma virus. Socioeconomic and cultural determinants also play a critical role, as populations with limited access to healthcare services or strong social taboos surrounding genital illness tend to present late, often with advanced disease. 1 Despite being uncommon in developed nations, penile carcinoma remains a significant health burden in developing and resource-constrained regions, where it accounts for a larger proportion of male malignancies. 2 The clinical presentation can range from small, painless nodules or erythematous plaques to extensive ulcer proliferative growths associated with foul-smelling discharge, bleeding, and secondary infection. Regional lymph node involvement, particularly of the inguinal nodes, is a common feature in neglected cases and significantly worsens prognosis. 3 Early diagnosis and timely intervention are essential, as localized disease can be effectively treated with organ-preserving procedures or partial penectomy, achieving excellent survival outcomes. Many men come for treatment only when the cancer is advanced. At this stage, they may need major surgery to remove the penis and nearby lymph nodes, followed by additional cancer treatment.⁴ The cause is most often because of embarrassment, illiteracy, not willing to understand genital lesion. This case report describes a man from a remote tribal community who developed penile cancer that went untreated for a long time. Because of social stigma and limited medical facilities, he only sought help when the condition had become severe, with a large ulcerated growth and enlarged lymph nodes in the groin. After surgery that involved removing the penis and affected lymph nodes, his recovery was smooth, and his mental state improved as well. The case draws attention to how cultural attitudes and poor healthcare access can delay diagnosis and treatment, and it stresses how early medical attention and teamwork among specialists can make a major difference, particularly in areas with scarce resources. The case is unique due to the prolonged delay in seeking medical attention, a scenario rarely seen in current practice. It highlights how social stigma, poor awareness, and limited healthcare access contribute to disease neglect. This report offers valuable insight into the natural course of untreated penile carcinoma and underscores the need for early detection and public education. CASE PRESENTATION A 54 yrs middle age male from a remote tribal village presented with an ulcerative, foul-smelling penile lesion for the past eight months. Initially, he noted a small, painless nodule on the glans penis, which progressively enlarged, ulcerated, and began discharging pus and blood. Due to feelings of shame and a lack of healthcare access, he did not consult any physician. In the past two months, the patient developed increasing pain, difficulty urinating, and swelling in both groins. He also reported weight loss, fatigue, and low-grade intermittent fever. No significant Medical, family, and psycho-social history . On examination, there was a large, ulcer proliferative growth measuring approximately 8 × 7 cm involving the glans and shaft of the penis, with necrotic slough and bleeding on touch (Fig. 1 ). Bilateral inguinal lymphadenopathy was present, with hard, matted, fixed nodes and overlying skin changes. Squamous cell carcinoma was seen on histopathology.Ultrasound abdomen and chest X-ray showed no evidence of distant metastasis. MRI of the pelvis was advised to assess the extent of local invasion and lymph node involvement; however, the patient refused the investigation due to fear and anxiety about the procedure. Hence, clinical and intraoperative findings were used to guide staging and treatment planning. The patient was started on intravenous antibiotics and analgesics to manage local infection and pain. After adequate counselling and stabilization, he underwent a total penectomy with bilateral inguinal lymphadenectomy under general anesthesia. Postoperatively, the wound healed well, and he was discharged with instructions for follow-up. Outcome and Follow-Up : The patient was referred to a regional cancer centre for adjuvant radiotherapy, as per oncological protocol. When patient came after one month, there were no sign of recurrence. He was advised to come after every three month for follow up. DISCUSSION Penile carcinoma is an uncommon yet aggressive cancer, with squamous cell carcinoma being the most common type. Early detection is essential, as localized tumors can often be treated with organ-sparing surgery or partial penectomy, resulting in good cancer control and preservation of function.6 Delayed presentation, as exemplified in this patient, is frequently influenced by sociocultural stigma, psychological denial, and limited access to healthcare, particularly in underserved or tribal populations. Such delays commonly lead to advanced ulceroproliferative lesions with regional lymph node involvement, thereby increasing morbidity and complicating clinical management. 7 Gilles Adans-Deste et al., in their study, discuss about old male patient who had who developed penile carcinoma secondary to prolonged immunosuppression therapy as. The patient initially disregarded early symptoms, resulting in a large, untreated tumor. In contrast, the present case occurred in an immunocompetent individual, highlighting that delayed presentation and advanced disease can occur even in the absence of immunosuppression, emphasizing the role of sociocultural and healthcare access factors in disease progression. 8 Wen Gao et al. reported that delayed presentation of penile carcinoma is particularly common among rural and single men, often resulting in advanced tumor stage, increased regional lymph node involvement, and poorer survival outcomes. The primary factors contributing to such delays included sociocultural stigma, embarrassment, limited awareness, rural residence, and nonspecific early symptoms that were frequently ignored or misinterpreted as minor infections. This is similar to the current case, where stigma and limited access to healthcare probably delayed the patient from seeking medical attention, resulting in the disease being more advanced by the time treatment was sought. 9 A study from Sweden by Skeppner E and colleagues found that almost two-thirds of men with penile cancer waited more than six months before seeing a doctor. The main reasons for the delay were embarrassment, confusing early symptoms with minor skin conditions like eczema or dermatitis, and not having enough knowledge about the disease. 10 Madsen and colleagues found that many men avoided seeing a doctor because they were embarrassed, did not notice early signs, or knew little about the disease. This often allowed the cancer to progress, resulting in more serious cases and poorer outcomes, as seen in this patient. 11 Chengalvarayan and Patravale, in a recent study from India, found that men who looked after their health closely were quicker to notice any warning signs of penile cancer and went to the doctor earlier, making treatment easier and more effective. Men with little knowledge about health often ignored early signs and only went to a doctor when the cancer had already progressed. This makes it clear that teaching people about health and running local awareness programs can help them recognize problems sooner and get treatment on time. 12 Highlighting cases of neglected penile cancer can increase awareness and make it easier for people to pay attention to genital health. It helps them recognize early warning signs, understand the risks of delaying treatment, and encourages timely medical care. Providing this information, especially in rural or less-informed areas, can lead to earlier diagnosis, better treatment, and improved recovery and survival. CONCLUSION Penile cancer is rare, but it can progress rapidly when diagnosis and treatment are delayed, often due to social stigma or limited access to medical care. This case highlights the importance of early recognition and timely surgical management. Increasing public awareness, providing proper patient education, and improving healthcare accessibility are crucial to prevent delays and enhance both survival and quality of life. Declarations Acknowledgment (optional) Not applicable Statement of Ethics Consent to publish statement and participation : written informed consent was obtained from the patient to publish the details of their medical case and any accompanying images. Conflict of Interest Statement There are no any possible conflicts of interest. Funding Sources No funding was received for this publication Author Contributions All the Author's Contributions are as per I.C.M.J.E. Criteria for Authorship. References Chahoud J, Slaton JW. Penile cancer: epidemiology, diagnosis, and management. Oncol Lett. 2017;14:12–18.2. Misra S, Chaturvedi A, Misra NC, et al. Penile carcinoma: a retrospective study of 65 patients. BJU Int. 2004;94:1051–1055. Van Poppel H, Watkin NA, Osanto S, et al. Penile cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013;24 Suppl 6:vi115–vi124. Kamel MH, Spiess PE. Contemporary management of penile cancer. Curr Opin Urol. 2018;28(1):38–45. Douglawi A, Al-Sayed M, Al-Haddad S. Updates on the epidemiology and risk factors for penile cancer. TUMOR. 2017;38(6):15046. doi:10.21037/tau.2017.05.19. Hakenberg OW, Compérat E, Minhas S, et al. EAU guidelines on penile cancer: 2020 update. Eur Urol. 2020;77:262–279. Amicuzi, U., Grillo, M., Stizzo, M., & Barone, B. (2024). Exploring the multifactorial landscape of penile cancer: A comprehensive analysis of risk factors. Journal of Clinical Medicine, 14(16), 1790. https://doi.org/10.3390/jcm14161790 Adans-Dester G, Evrard P, D'Hondt L, Carlier FM. The need to enhance intimacy care in immunosuppressed patients: a case report of neglected penile cancer in a long-term lung transplant recipient. Transplant Direct. 2025;11(3):e1763. doi:10.1097/TXD.0000000000001763. Gao W, Song L, Yang J, Chen G, Zhang H, Li X. Risk factors and negative consequences of patient’s delay for penile carcinoma. World J Surg Oncol. 2016;14:252. doi:10.1186/s12957-016-0863-z. Skeppner E, Andersson SO, Johansson JE, Windahl T. Initial symptoms and delay in patients with penile carcinoma. Scand J Urol Nephrol. 2012 Oct;46(5):319-25. doi: 10.3109/00365599.2012.677473. Epub 2012 Jul 2. PMID: 22989150 Madsen BS, van Diermen B, Weyde S, Fode M, Jakobsen JK, Østergren P. Initial symptoms and delay in patients with penile carcinoma. Scand J Urol Nephrol. 2012;46(5):319–325. doi:10.3109/00365599.2012.689425. Chengalvarayan P, Patravale V. A cross-sectional study evaluating the association of patient literacy with the stage of penile carcinoma. Int J Adv Res. 2023;11(6):45–52. doi:10.21474/IJAR01/46584. Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8102882","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":544353609,"identity":"bdfb6842-7233-4a6d-85df-a103569f63b7","order_by":0,"name":"varsha yeshwant Lamture","email":"data:image/png;base64,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","orcid":"","institution":"datta meghe institute of medical science,wanadongari.nagpur.india","correspondingAuthor":true,"prefix":"","firstName":"varsha","middleName":"yeshwant","lastName":"Lamture","suffix":""},{"id":544353671,"identity":"5ba8e569-c9af-4f4f-8fe6-d0bf2dc92787","order_by":1,"name":"yeshwant lamture","email":"","orcid":"","institution":"datta meghe institute of medical science,wanadongari.nagpur.india","correspondingAuthor":false,"prefix":"","firstName":"yeshwant","middleName":"","lastName":"lamture","suffix":""}],"badges":[],"createdAt":"2025-11-13 07:58:30","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":true,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-8102882/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8102882/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":96242176,"identity":"655097ab-e077-4257-a9d4-149acd0a6cac","added_by":"auto","created_at":"2025-11-19 07:12:16","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":888110,"visible":true,"origin":"","legend":"","description":"","filename":"MAINABSTRACTFORNEGLECTEDPENILECARCINOMA.docx","url":"https://assets-eu.researchsquare.com/files/rs-8102882/v1/41fcbdf0f16da04971514a87.docx"},{"id":95896045,"identity":"2d75ab5e-d025-4f5f-bc50-eafc2557cb38","added_by":"auto","created_at":"2025-11-14 07:18:33","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":342,"visible":true,"origin":"","legend":"","description":"","filename":"rs8102882.json","url":"https://assets-eu.researchsquare.com/files/rs-8102882/v1/943be90b10eae6c1210409f7.json"},{"id":95896051,"identity":"56950528-fef3-46e6-b147-608a397584f6","added_by":"auto","created_at":"2025-11-14 07:18:34","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":32132,"visible":true,"origin":"","legend":"","description":"","filename":"rs81028820enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-8102882/v1/87247f1dd6e394d571fceb99.xml"},{"id":95896052,"identity":"dc0a9e78-162a-40cb-afab-2e7ec3ca2af1","added_by":"auto","created_at":"2025-11-14 07:18:34","extension":"png","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":867702,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8102882/v1/1c0123e9c4956a40587af39d.png"},{"id":95896050,"identity":"240ff05b-0ce7-4739-b9ec-da21b8738633","added_by":"auto","created_at":"2025-11-14 07:18:34","extension":"png","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":119769,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8102882/v1/0dd5e0f61d8c1cb179abcb7b.png"},{"id":96243196,"identity":"c25497f2-0be2-4e0e-af93-a4b582eadb11","added_by":"auto","created_at":"2025-11-19 07:15:50","extension":"xml","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":30518,"visible":true,"origin":"","legend":"","description":"","filename":"rs81028820structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-8102882/v1/b50e59381e4ec042b41afd18.xml"},{"id":95896046,"identity":"dafd83e6-5e93-46eb-b44c-831d05a31245","added_by":"auto","created_at":"2025-11-14 07:18:34","extension":"html","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":35949,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8102882/v1/cad9af9b13fd799ef8c48df1.html"},{"id":96243076,"identity":"29de2fb9-91bd-4d21-bf49-248959afd7b8","added_by":"auto","created_at":"2025-11-19 07:15:26","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":867707,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eYellow arrow showing a large, ulceroproliferative, necrotic mass involving the glans and shaft of the penis in a middle-aged male.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"Picture1.png","url":"https://assets-eu.researchsquare.com/files/rs-8102882/v1/0e28684bf14d8b8c9f4197b2.png"},{"id":96255146,"identity":"9703b31b-af5c-4588-b647-c3cb2d566a88","added_by":"auto","created_at":"2025-11-19 07:47:51","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1851522,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8102882/v1/a4a6c140-c51c-411a-9f62-ebb148f3631b.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eNeglected Case of Penile Carcinoma: A Case Report\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003ePenile carcinoma is a rare malignancy, representing less than 1% of all male cancers globally, but it carries significant morbidity and mortality when diagnosed at an advanced stage. The majority of cases are histologically squamous cell carcinoma, which arises from the epithelial lining of the glans, foreskin, or shaft. Multiple risk factors have been implicated in its pathogenesis, including poor genital hygiene, phimosis, chronic balanitis, smoking, genital viral infection due to human papilloma virus. Socioeconomic and cultural determinants also play a critical role, as populations with limited access to healthcare services or strong social taboos surrounding genital illness tend to present late, often with advanced disease.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eDespite being uncommon in developed nations, penile carcinoma remains a significant health burden in developing and resource-constrained regions, where it accounts for a larger proportion of male malignancies.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e The clinical presentation can range from small, painless nodules or erythematous plaques to extensive ulcer proliferative growths associated with foul-smelling discharge, bleeding, and secondary infection. Regional lymph node involvement, particularly of the inguinal nodes, is a common feature in neglected cases and significantly worsens prognosis.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eEarly diagnosis and timely intervention are essential, as localized disease can be effectively treated with organ-preserving procedures or partial penectomy, achieving excellent survival outcomes. Many men come for treatment only when the cancer is advanced. At this stage, they may need major surgery to remove the penis and nearby lymph nodes, followed by additional cancer treatment.⁴ The cause is most often because of embarrassment, illiteracy, not willing to understand genital lesion.\u003c/p\u003e\u003cp\u003eThis case report describes a man from a remote tribal community who developed penile cancer that went untreated for a long time. Because of social stigma and limited medical facilities, he only sought help when the condition had become severe, with a large ulcerated growth and enlarged lymph nodes in the groin. After surgery that involved removing the penis and affected lymph nodes, his recovery was smooth, and his mental state improved as well. The case draws attention to how cultural attitudes and poor healthcare access can delay diagnosis and treatment, and it stresses how early medical attention and teamwork among specialists can make a major difference, particularly in areas with scarce resources.\u003c/p\u003e\u003cp\u003eThe case is unique due to the prolonged delay in seeking medical attention, a scenario rarely seen in current practice. It highlights how social stigma, poor awareness, and limited healthcare access contribute to disease neglect. This report offers valuable insight into the natural course of untreated penile carcinoma and underscores the need for early detection and public education.\u003c/p\u003e"},{"header":"CASE PRESENTATION","content":"\u003cp\u003eA 54 yrs middle age male from a remote tribal village presented with an ulcerative, foul-smelling penile lesion for the past eight months. Initially, he noted a small, painless nodule on the glans penis, which progressively enlarged, ulcerated, and began discharging pus and blood. Due to feelings of shame and a lack of healthcare access, he did not consult any physician. In the past two months, the patient developed increasing pain, difficulty urinating, and swelling in both groins. He also reported weight loss, fatigue, and low-grade intermittent fever. No significant Medical, family, and psycho-social history .\u003c/p\u003e\u003cp\u003eOn examination, there was a large, ulcer proliferative growth measuring approximately 8 \u0026times; 7 cm involving the glans and shaft of the penis, with necrotic slough and bleeding on touch (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Bilateral inguinal lymphadenopathy was present, with hard, matted, fixed nodes and overlying skin changes.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eSquamous cell carcinoma was seen on histopathology.Ultrasound abdomen and chest X-ray showed no evidence of distant metastasis. MRI of the pelvis was advised to assess the extent of local invasion and lymph node involvement; however, the patient refused the investigation due to fear and anxiety about the procedure. Hence, clinical and intraoperative findings were used to guide staging and treatment planning. The patient was started on intravenous antibiotics and analgesics to manage local infection and pain. After adequate counselling and stabilization, he underwent a total penectomy with bilateral inguinal lymphadenectomy under general anesthesia. Postoperatively, the wound healed well, and he was discharged with instructions for follow-up. \u003cb\u003eOutcome and Follow-Up\u003c/b\u003e: The patient was referred to a regional cancer centre for adjuvant radiotherapy, as per oncological protocol. When patient came after one month, there were no sign of recurrence. He was advised to come after every three month for follow up.\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003ePenile carcinoma is an uncommon yet aggressive cancer, with squamous cell carcinoma being the most common type. Early detection is essential, as localized tumors can often be treated with organ-sparing surgery or partial penectomy, resulting in good cancer control and preservation of function.6 Delayed presentation, as exemplified in this patient, is frequently influenced by sociocultural stigma, psychological denial, and limited access to healthcare, particularly in underserved or tribal populations. Such delays commonly lead to advanced ulceroproliferative lesions with regional lymph node involvement, thereby increasing morbidity and complicating clinical management. \u003csup\u003e7\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eGilles Adans-Deste et al., in their study, discuss about old male patient who had who developed penile carcinoma secondary to prolonged immunosuppression therapy as. The patient initially disregarded early symptoms, resulting in a large, untreated tumor. In contrast, the present case occurred in an immunocompetent individual, highlighting that delayed presentation and advanced disease can occur even in the absence of immunosuppression, emphasizing the role of sociocultural and healthcare access factors in disease progression.\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eWen Gao et al. reported that delayed presentation of penile carcinoma is particularly common among rural and single men, often resulting in advanced tumor stage, increased regional lymph node involvement, and poorer survival outcomes. The primary factors contributing to such delays included sociocultural stigma, embarrassment, limited awareness, rural residence, and nonspecific early symptoms that were frequently ignored or misinterpreted as minor infections. This is similar to the current case, where stigma and limited access to healthcare probably delayed the patient from seeking medical attention, resulting in the disease being more advanced by the time treatment was sought.\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e A study from Sweden by Skeppner E and colleagues found that almost two-thirds of men with penile cancer waited more than six months before seeing a doctor. The main reasons for the delay were embarrassment, confusing early symptoms with minor skin conditions like eczema or dermatitis, and not having enough knowledge about the disease.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eMadsen and colleagues found that many men avoided seeing a doctor because they were embarrassed, did not notice early signs, or knew little about the disease. This often allowed the cancer to progress, resulting in more serious cases and poorer outcomes, as seen in this patient.\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eChengalvarayan and Patravale, in a recent study from India, found that men who looked after their health closely were quicker to notice any warning signs of penile cancer and went to the doctor earlier, making treatment easier and more effective. Men with little knowledge about health often ignored early signs and only went to a doctor when the cancer had already progressed. This makes it clear that teaching people about health and running local awareness programs can help them recognize problems sooner and get treatment on time.\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eHighlighting cases of neglected penile cancer can increase awareness and make it easier for people to pay attention to genital health. It helps them recognize early warning signs, understand the risks of delaying treatment, and encourages timely medical care. Providing this information, especially in rural or less-informed areas, can lead to earlier diagnosis, better treatment, and improved recovery and survival.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003ePenile cancer is rare, but it can progress rapidly when diagnosis and treatment are delayed, often due to social stigma or limited access to medical care. This case highlights the importance of early recognition and timely surgical management. Increasing public awareness, providing proper patient education, and improving healthcare accessibility are crucial to prevent delays and enhance both survival and quality of life.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgment\u003c/strong\u003e (optional)\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatement of Ethics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConsent to publish statement and participation : written informed consent was obtained from the patient to publish the details of their medical case and any accompanying images.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere are no any possible conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Sources\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was received for this publication\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll the Author\u0026apos;s Contributions are as per I.C.M.J.E. Criteria for Authorship.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eChahoud J, Slaton JW. Penile cancer: epidemiology, diagnosis, and management. Oncol Lett. 2017;14:12\u0026ndash;18.2.\u003c/li\u003e\n \u003cli\u003eMisra S, Chaturvedi A, Misra NC, et al. Penile carcinoma: a retrospective study of 65 patients. BJU Int. 2004;94:1051\u0026ndash;1055.\u003c/li\u003e\n \u003cli\u003eVan Poppel H, Watkin NA, Osanto S, et al. Penile cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013;24 Suppl 6:vi115\u0026ndash;vi124.\u003c/li\u003e\n \u003cli\u003eKamel MH, Spiess PE. Contemporary management of penile cancer. Curr Opin Urol. 2018;28(1):38\u0026ndash;45.\u003c/li\u003e\n \u003cli\u003eDouglawi A, Al-Sayed M, Al-Haddad S. Updates on the epidemiology and risk factors for penile cancer. TUMOR. 2017;38(6):15046. doi:10.21037/tau.2017.05.19.\u003c/li\u003e\n \u003cli\u003eHakenberg OW, Comp\u0026eacute;rat E, Minhas S, et al. EAU guidelines on penile cancer: 2020 update. Eur Urol. 2020;77:262\u0026ndash;279.\u003c/li\u003e\n \u003cli\u003eAmicuzi, U., Grillo, M., Stizzo, M., \u0026amp; Barone, B. (2024). Exploring the multifactorial landscape of penile cancer: A comprehensive analysis of risk factors. Journal of Clinical Medicine, 14(16), 1790. https://doi.org/10.3390/jcm14161790\u003c/li\u003e\n \u003cli\u003eAdans-Dester G, Evrard P, D\u0026apos;Hondt L, Carlier FM. The need to enhance intimacy care in immunosuppressed patients: a case report of neglected penile cancer in a long-term lung transplant recipient. Transplant Direct. 2025;11(3):e1763. doi:10.1097/TXD.0000000000001763.\u003c/li\u003e\n \u003cli\u003eGao W, Song L, Yang J, Chen G, Zhang H, Li X. Risk factors and negative consequences of patient\u0026rsquo;s delay for penile carcinoma. World J Surg Oncol. 2016;14:252. doi:10.1186/s12957-016-0863-z.\u003c/li\u003e\n \u003cli\u003eSkeppner E, Andersson SO, Johansson JE, Windahl T. Initial symptoms and delay in patients with penile carcinoma. Scand J Urol Nephrol. 2012 Oct;46(5):319-25. doi: 10.3109/00365599.2012.677473. Epub 2012 Jul 2. PMID: 22989150\u003c/li\u003e\n \u003cli\u003eMadsen BS, van Diermen B, Weyde S, Fode M, Jakobsen JK, \u0026Oslash;stergren P. Initial symptoms and delay in patients with penile carcinoma. Scand J Urol Nephrol. 2012;46(5):319\u0026ndash;325. doi:10.3109/00365599.2012.689425.\u003c/li\u003e\n \u003cli\u003eChengalvarayan P, Patravale V. A cross-sectional study evaluating the association of patient literacy with the stage of penile carcinoma. Int J Adv Res. 2023;11(6):45\u0026ndash;52. doi:10.21474/IJAR01/46584.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Datta Meghe Institute of Medical Sciences","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Penile carcinoma, squamous cell carcinoma, penectomy, late presentation","lastPublishedDoi":"10.21203/rs.3.rs-8102882/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8102882/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003ePenile carcinoma, most commonly squamous cell carcinoma, is a rare but aggressive malignancy, with prognosis improving significantly when diagnosed early. Social stigma, limited awareness, and poor access to healthcare often result in delayed presentation, negatively affecting outcomes. We report a middle-aged man from a remote tribal area who presented with an eight-month history of a painless penile nodule that gradually progressed to a large ulceroproliferative lesion involving the glans and shaft, associated with bilateral inguinal lymphadenopathy. Penectomy procedure was done after Histopathological examination which showed squamous cell carcinoma. He was advised follow after after 1month and later 3month subsequently.\u003c/p\u003e","manuscriptTitle":"Neglected Case of Penile Carcinoma: A Case Report","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-14 07:18:29","doi":"10.21203/rs.3.rs-8102882/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"37d289d0-991f-4566-92cb-ddd98a182509","owner":[],"postedDate":"November 14th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":57972807,"name":"Surgery"}],"tags":[],"updatedAt":"2025-11-14T07:18:29+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-14 07:18:29","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8102882","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8102882","identity":"rs-8102882","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}