Penile squamous cell carcinoma masquerading as Fournier's Gangrene: A case of a young patient with aggressive, metastatic disease

Fournier's gangrene (FG) is a rapidly progressive necrotizing fasciitis of the perineum and genitals. Although most cases result from polymicrobial infection, rare reports describe secondary causes that mimic FG, including malignancy. We present a man in his forties with clinical and radiographic findings concerning for FG who was ultimately found to have locally advanced, metastatic penile squamous cell carcinoma. This case illustrates that necrotic, infected tumors may masquerade as necrotizing soft-tissue infections, delaying oncologic diagnosis and limiting therapeutic options. Early consideration of underlying malignancy is warranted in atypical, refractory, or rapidly progressive presentations of presumed FG.