Diagnosis: 1. Clinically, early manifestation is papule-like, warts or ulcerated lesions on the inner plate of foreskin and head of penis, which are usually painless, but after complicated infection, pain, itching and pus and blood discharge may appear, and the longer course of the disease shows typical cauliflower-like growth or deep ulceration of tumor, and most of penis is destroyed by tumor. 2.86-98% of penile cancer patients have prepuce or circumcision. 3.Biopsy should be taken at the edge of tumor or suspicious parts, and if the wound does not heal for a long time after circumcision, biopsy should also be taken. 4.The enlarged lymph nodes in the groin may not necessarily be cancer metastasis; to determine whether there is lymph node metastasis, needle aspiration biopsy or lymph node excision biopsy should be performed; the enlarged lymph nodes located in the saphenous vein into the upper medial femoral vein are mostly the sites of early metastasis of penile cancer and should be biopsied first. Lymphography, CT and MRI of the pelvis, chest and abdomen, and other imaging examinations are feasible to understand whether there are lymphatic metastases in other parts. 5.Differential diagnosis: It should be distinguished from syphilis, soft chancre, tuberculosis of penile head and amoebiasis, etc. It should be done by smear of secretion, biopsy and serological examination. The treatment of primary tumor has various methods, and in principle, it should be selected according to the extent of tumor spread. 1. Local excision can be done for very small and superficial tumors. Small, low-grade malignant tumors can also be treated with radiation therapy to preserve sexual organs and functions, in addition, electrocautery, laser, freezing and other treatments can be used. 2.Larger tumors, such as those with diameter greater than 2cm, should be partially excised, and the penis should be cut off at a distance of 2cm from the tumor. If you want to keep longer penis, you can make penile spongiogram before surgery and cut off the penis at the proximal end of filling defect. If frozen section shows that there is still tumor at the severed end, then cut off another section until the examination is negative. If the residual penis is too short, penile reconstruction can be done 1-2 years after surgery. If the tumor invades widely, total penile excision should be made at the root and perineal urethrostomy should be made. If the tumor invades into scrotum, perineum, abdominal wall or pubic bone, if there is no extensive metastasis, total excision of vulva, together with bladder, prostatic seminal vesicles, part of pubic arch, pubic symphysis and part of abdominal wall is feasible. Tissue defects in the perineum can be repaired with a thin femoral muscle flap with a tip. Treatment of regional lymph nodes: At present, prophylactic lymph node dissection is not recommended, and positive lymph nodes are found and then dissected. The principles of dissection scope and indications are: 1. Smaller superficial exophytic tumors, which do not invade the corpus cavernosum and have no suspicious lymph nodes, are not dissected, and are followed up regularly. 2.Tumors larger than 2cm, invading the cavernous body or penile shaft, and low-differentiated, infiltrative tumors, due to the high incidence of lymph node metastasis, bilateral inguinal lymph node dissection should be performed. 3. Those with positive inguinal lymph nodes should undergo pelvic lymph node dissection, and those with extensive metastasis in pelvic lymph nodes should give up surgery and use chemotherapy and radiotherapy instead. Radiotherapy is suitable for small and superficial carcinoma or ulcerated carcinoma without lymph node metastasis and without invasion of penile corpus cavernosum, and tumor combined with inflammation should be controlled before radiotherapy. Young patients with small early stage penile cancer can be treated with radiotherapy to preserve sexual function, and if the treatment fails, then surgery. High-dose radiotherapy can cause urethral fistula and urethral stricture. Chemotherapy drugs for penile cancer include fluorouracil, cyclophosphamide, bleomycin, etc., which can be combined with surgery and radiotherapy. The prognosis of penile cancer is related to the stage of tumor, early and late treatment, treatment method, patient’s age and malignancy of tumor.