Mohs micrographic surgery of penile squamous cell carcinoma in situ with urethral extension.

Squamous cell carcinoma in situ (SCCIS) of the glans penis with urethral involvement is a rare entity that is well-suited for Mohs micrographic surgery (MMS) given its high risk of local recurrence. However, MMS in this area is technically challenging, and surgery at this site often relies on the use of meatotomy for improved tumor visualization. We describe a less invasive approach to harvesting Mohs layers of the glans penis and distal urethra that obviates the need for meatotomy. For SCCIS tumors limited to the distal urethra, this is a straightforward technique that minimizes morbidity while still benefitting from the complete margin assessment and high cure rates associated with MMS.