A dramatic case of genital radionecrosis.

BACKGROUND: Epidermoid carcinoma of the penis presents in 1% of malignant tumors in men. Penis cancer treatment has traditionally been total or partial amputation. There are authors who consider radiation to be part of penis cancer treatment in select cases--especially the use of brachytherapy and external radiation. CLINICAL CASE: The case of a 48-year-old male who in 2004 presented with an ulcerated lesion of the penis that was left unattended to is presented. Two years later, he sought medical attention and physical examination revealed an ulcerated penile lesion with poorly defined edges and limited to the glans. DIAGNOSIS: The lesion was biopsied and the histopathological study reported Epidermoid Carcinoma. After radiological studies, it was classified as stage T2-N0-M0. TREATMENT: Total penectomy without lymphadenectomy was performed. The patient received adjuvant treatment of 15 sessions of cobalt radiation treatment at a dose of 3,500 cGy. Six months later, the patient noticed the presence of erythema at the genital and inguinal level which later ulcerated and extended toward the perineum. The disease progressed tragically and the patient died 2 years later.