Question
A patient presents with a penile lesion staged as T3, with clinically palpable lymph nodes. What is the most appropriate management?
| A. |
Penectomy
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| B. |
Penectomy with superficial node dissection
|
| C. |
Penectomy with deep ilioinguinal node dissection
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| D. |
Chemoradiotherapy
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Show Answer
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Correct Answer � C
Explanation
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|
Penectomy (a): This is a surgical procedure where part or all of the penis is removed. While this might be appropriate for early-stage penile cancer, it would not address the clinically palpable lymph nodes, which are concerning for possible metastatic spread.
Penectomy with superficial node dissection (b): Superficial node dissection involves removing lymph nodes that are closer to the surface. However, in the case of clinically palpable lymph nodes (suggesting significant lymph node involvement), a more extensive lymph node dissection is usually warranted.
Penectomy with deep ilioinguinal node dissection (c): This is the most appropriate management for a T3 penile lesion with clinically palpable lymph nodes. The deep ilioinguinal node dissection involves the removal of lymph nodes from deeper regions, which is crucial for adequate staging and treatment, especially when there is evidence of lymph node involvement.
Chemoradiotherapy (d): While chemoradiotherapy can be used in some cases of penile cancer, especially for palliative care or in cases where surgery is not feasible, it is generally not the first line of treatment for T3 lesions with clinically significant lymph node involvement.
Given the staging (T3) and the presence of clinically palpable lymph nodes, the best management approach is penectomy with deep ilioinguinal node dissection, making c. Penectomy with deep ilioinguinal node dissection the correct answer.
