[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [General pathology](https://durgical.com/en/general-pathology/) › [Lower urinary tract and male genital system](https://durgical.com/en/general-pathology/areas/urinary-male/) › Penile tumours

# Penile tumours

- Lesion

HPV and chronic inflammation lead to warts, precancerous lesions and squamous cell carcinoma of the penis.

Updated Nov 12, 2026

## Key points

- Condyloma: HPV 6 and 11; papillary lesion with koilocytes.
- HPV-associated PeIN and carcinoma: high-risk HPV 16 (and 18); basaloid and warty types; p16 positive.
- HPV-independent: lichen sclerosus, phimosis, chronic inflammation; keratinizing and verrucous types.
- Risk factors: lack of circumcision, phimosis, poor hygiene, HPV, smoking.
- Spread first to inguinal lymph nodes; giant condyloma (Buschke-Löwenstein) is a verrucous carcinoma.

## What it is

Condyloma acuminatum is a benign wart caused by low-risk HPV, mainly types 6 and 11. Penile intraepithelial neoplasia (PeIN) is the precursor of carcinoma and comes in HPV-associated forms, which clinically include Bowen disease, erythroplasia of Queyrat and bowenoid papulosis, and an HPV-independent differentiated form linked to lichen sclerosus. Invasive squamous cell carcinoma is classified (WHO 2022) as HPV-associated (basaloid, warty) or HPV-independent (usual keratinizing, verrucous). It is more common in uncircumcised men with phimosis, poor hygiene and smoking, and in parts of Latin America, Africa and Asia.

## Structure

- Condyloma: branching papillary fronds with acanthosis, parakeratosis and koilocytes (clear halos around wrinkled nuclei).
- PeIN: atypical squamous cells filling the epidermis, either basaloid or differentiated.
- Invasive carcinoma: grey, crusted, papillary or flat ulcerated mass on the glans or inner foreskin.
- Verrucous carcinoma: exophytic, well-differentiated, with pushing borders; rarely metastasizes.

## Clinical notes

- Penile cancer is rare in high-income countries but more frequent in parts of Latin America such as Brazil, where it is linked to HPV and lack of circumcision.
- HPV vaccination of boys prevents condylomas and some penile cancers.

## Memory aid

Six and eleven make warts; sixteen makes cancer; a tight foreskin breeds the rest.

## Test yourself

Think of the answer, then tap the question to see it.

## Which HPV types cause condyloma acuminatum?

Low-risk types 6 and 11.

## What are koilocytes?

Squamous cells with a wrinkled, dark nucleus surrounded by a clear halo, typical of HPV infection.

## Which lymph nodes receive the first metastases of penile carcinoma?

The inguinal lymph nodes.

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## Elsewhere in DurgiPedia

- [Oncogenic viruses and H. pylori: the table to know](https://durgical.com/en/general-pathology/oncogenic-viruses-and-h-pylori-the-table-to-know/)
- [Dysplasia and carcinoma in situ](https://durgical.com/en/general-pathology/dysplasia-and-carcinoma-in-situ/)

## Connections

## Related 4

- [The penis: hypospadias, epispadias, phimosis and balanoposthitis](https://durgical.com/en/general-pathology/the-penis-hypospadias-epispadias-phimosis-and-balanoposthitis/)
- [Oncogenic viruses and H. pylori: the table to know](https://durgical.com/en/general-pathology/oncogenic-viruses-and-h-pylori-the-table-to-know/)
- [Dysplasia and carcinoma in situ](https://durgical.com/en/general-pathology/dysplasia-and-carcinoma-in-situ/)
- [The anal canal: haemorrhoids, condyloma and anal carcinoma](https://durgical.com/en/general-pathology/the-anal-canal-haemorrhoids-condyloma-and-anal-carcinoma/)

## Related conditions 3

- [Human papillomavirus (HPV) infection](https://durgical.com/en/conditions/human-papillomavirus-infection/)
- [Viral warts (verruca)](https://durgical.com/en/conditions/viral-warts/)
- [Phimosis](https://durgical.com/en/conditions/phimosis/)

## Microorganisms 1

- [Human papillomavirus](https://durgical.com/en/microbiology/human-papillomavirus/)

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Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.

Sources: [Penile Cancer Treatment](https://www.cancer.gov/types/penile/patient/penile-treatment-pdq) (National Cancer Institute, 2025); [HPV](https://medlineplus.gov/hpv.html) (MedlinePlus, US National Library of Medicine, 2025).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/general-pathology/penile-tumours/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/general-pathology/penile-tumours/