The First Moroccan Experience of Personalized Template‑Guided High-Dose-Rate Brachytherapy for Organ Preservation in Glans Squamous Cell Carcinoma: Game Changer or Challenge?

Squamous cell carcinoma of the glans is a rare malignancy, often diagnosed at an advanced stage, and its management remains challenging. Therapeutic approaches are multimodal and depend on tumor stage, risk of recurrence, nodal involvement, and disease extent. Organ-preserving strategies are increasingly advocated, particularly in patients who refuse mutilating surgery. We report the first Moroccan case of a 50-year-old man diagnosed with a T2N0M0 glans carcinoma, treated with high-dose-rate (HDR) brachytherapy using a customized template following refusal of partial penectomy. Initial treatment achieved adequate tumor coverage without acute toxicity, with no evidence of necrosis or skin ulceration. A superficial recurrence in the previously irradiated area was detected four months later and was successfully treated with salvage HDR brachytherapy. At 18 months of follow-up, urinary function was preserved and partial sexual function maintained, with no severe complications. This case illustrates that personalized HDR brachytherapy may represent a feasible, safe, and organ-preserving alternative in patients refusing mutilating surgery, supporting its applicability even in resource-limited settings.