Squamous cell carcinoma on neglected lichen sclerosus of the glans: When one disease hides another

Abstract

We report the case of a 45-year-old Moroccan man with a history of neglected lichen sclerosus of the glans, who presented with a penile tumor. Clinical examination revealed an ulcerated, exophytic keratotic lesion overlying a sclerotic, hypopigmented plaque. A biopsy performed at the junction of the lesion and underlying plaque confirmed a well-differentiated, infiltrating squamous cell carcinoma. Staging with thoraco-abdomino-pelvic CT scan showed bilateral pathological lymphadenopathy in the inguinal and pelvic regions. The patient underwent partial penectomy with bilateral lymph node dissection. Histological examination showed no lymph node involvement. Postoperative recovery was favorable, allowing for penile reconstruction three months later. This rare case highlights the importance of regular monitoring in patients with lichen sclerosus, due to its potential progression to differentiated intraepithelial neoplasia and invasive squamous cell carcinoma.