Treatment of choice of small preputial penile carcinoma is:
**Core Concept**
Preputial penile carcinoma refers to cancer of the foreskin, a common site for penile squamous cell carcinoma. The treatment of choice for small preputial penile carcinoma aims to balance oncologic efficacy with preservation of penile function and cosmesis.
**Why the Correct Answer is Right**
The treatment of choice for small preputial penile carcinoma is wide local excision with a margin of at least 1 cm. This approach allows for complete removal of the cancerous tissue while preserving as much penile tissue as possible. The excised tissue should be sent for histopathological examination to assess for margins and lymphovascular invasion. In some cases, sentinel lymph node biopsy may be considered to evaluate for lymph node metastasis.
**Why Each Wrong Option is Incorrect**
**Option A:** Radiotherapy is not the treatment of choice for small preputial penile carcinoma, as it may not provide adequate local control and can lead to significant side effects such as erectile dysfunction.
**Option B:** Chemotherapy is not typically used as a primary treatment for small preputial penile carcinoma, as it is more effective for advanced or metastatic disease.
**Option C:** Partial penectomy (removal of the penis) is a more aggressive approach that is usually reserved for larger or more advanced tumors.
**Clinical Pearl / High-Yield Fact**
The American Urological Association (AUA) guidelines recommend a multidisciplinary approach for the treatment of penile cancer, involving urologists, medical oncologists, and radiation oncologists.
**Correct Answer:** C. Partial penectomy (removal of the penis) is a more aggressive approach that is usually reserved for larger or more advanced tumors.