A 55-year-old male presents to the clinic with a 3-month history of a painless ulcer on the shaft of his penis. He first noticed the lesion after noticing some irritation and redness in the area. The ulcer has progressively grown in size but has not caused him significant pain. He also mentions occasional mild itching around the lesion but denies any discharge, bleeding, or foul odor. He has not experienced any difficulty urinating or pain during erections.

The patient is sexually active and has a history of multiple sexual partners. He admits to not consistently using condoms. He has no history of smoking, but he does consume alcohol moderately. The patient reports a history of poor hygiene and infrequent cleaning of his genital area. He has no significant medical history and is not on any regular medications.

On physical examination, the patient appears well-nourished with no signs of systemic illness. The genital examination reveals a 3 cm, firm, indurated ulcer on the shaft of the penis with well-defined borders. There is no visible discharge or erythema surrounding the lesion. No inguinal lymphadenopathy is noted. The patient’s prostate and testicles appear normal on examination.

A biopsy of the ulcer is performed, and histological examination confirms the diagnosis of squamous cell carcinoma (SCC) of the penis. Further imaging studies, including a pelvic CT scan, show no signs of regional or distant metastasis. The patient is referred to a urologist for staging and management. Treatment options include partial penectomy, radiation therapy, or chemotherapy, depending on the size and extent of the tumor.