This is an open access article under the terms of a license that permits non-commercial use, provided the original work is properly cited. © 2023 The Authors. Société Internationale d'Urologie Journal, published by the Société Internationale d'Urologie, Canada. Key Words Competing Interests Article Information Penile cancer, chemotherapy, radiotherapy, interdisciplinary communication None declared. Patient Consent: Obtained. Received on October 18, 2022 Accepted on October 22, 2022 Soc Int Urol J. 2023;4(2):150–152 DOI: 10.48083/GVTL9492 Complete Response of Primary Penile Tumor With Induction Paclitaxel, Ifosfamide, and Cisplatin (TIP) Chemotherapy Logan Zemp,1 Jad Chahoud,1 Peter A. Johnstone,2 Philippe E. Spiess1 1Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, United States 2 Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, United States The patient was a 53-year-old male who presented to Moffitt Cancer Center with a fungating lesion of the ventral penis and scrotum which was biopsy proven to be well-differentiated squamous cell carcinoma, invasive into at least the lamina propria, and unknown human papillomavirus (HPV) (Figure 1A). Presentation was delayed because of lack of health insurance. The penile lesion was mobile and inguinal lymph node (iLN) enlargement was not appreciated on physical examination. Staging CT and MRI imaging identified tumor effacement of the corpus spongiosum (Figure 1B), no evidence of iLN, pelvic, or distant metastases. The patient was counselled on radical penectomy due to concern for ≥ cT2 disease, but he adamantly refused penec- tomy despite guideline directed counselling[1]. The case was presented at Multidisciplinary tumor board (MDT) who favored penectomy, but patient preference was considered, and wide local excision with suprapubic catheter place- ment and staged penile urethroplasty after a period of observation to ensure adequate local control was discussed and presented to the patient. He refused. Additional MDT discussions led to recommendation for induction paclitaxel, ifosfamide, and cisplatin (TIP) chemotherapy due to limited treatment options. The patient underwent 4 cycles of TIP chemotherapy without major adverse events resulting in a complete response (Figure 1C and 1D). The patient underwent 28 fractions of external beam radiation to the iLNs. At most recent follow-up he has no evidence of disease. These clinical images document the complete response of a large primary penile tumor with TIP chemotherapy alone and importance of multidisciplinary care. Reference 1. Clark PE, Spiess PE, Agarwal N, Biagioli MC, Eisenberger MA, Greenberg RE, et al. Penile cancer: Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw.2013;11(5):594-615. 150 SIUJ • Volume 4, Number 2 • March 2023 SIUJ.ORG CLINICAL PICTURE https://orcid.org/0000-0002-7701-5070 mailto:Logan.Zemp%40Moffitt.org?subject=SIUJ https://orcid.org/0000-0002-8435-0264 https://orcid.org/0000-0003-4221-9388 https://orcid.org/0000-0002-5723-1972 http://SIUJ.org INITIAL PRESENTATION FIGURE 1. Representative photo of the penile lesion A) On initial presentation B) Pre-treatment sagittal and axial MRI demonstrating penile mass with effacement of the corpus spongiosum A B 151SIUJ.ORG SIUJ • Volume 4, Number 2 • March 2023 Complete Response of Primary Penile Tumor With Induction Paclitaxel, Ifosfamide, and Cisplatin (TIP) Chemotherapy http://SIUJ.org STATUS POST TIP CHEMO C) Penile lesion status post 3 cycles paclitaxel, ifosfamide, and cisplatin (TIP) Chemotherapy D) Post-treatment MRI images with resolution of primary penile tumor C D 152 SIUJ • Volume 4, Number 2 • March 2023 SIUJ.ORG CLINICAL PICTURE http://SIUJ.org