(UroToday.com) At the 2021 American Urological Association (AUA) Summer School session on the updates in the management of penile cancer, Dr. Christopher Protzel from the University of Rostock discussed the management of bulky inguinal and pelvic lymph nodes. Dr. Protzel started with a case presentation of a 49-year-old male, former smoker, with no medical comorbidities who presented after a partial penectomy with poorly differentiated squamous cell carcinoma infiltrating the corpus cavernosum (pT3), negative margins, with palpable inguinal lymph nodes. In patients with palpable lymph nodes, there are several diagnostic options available. Fine needle aspiration cytology has a sensitivity of 93% and specificity of 91%, whereas PET/CT has a sensitivity of 75%. In cases of palpable lymph nodes, dynamic sentinel node biopsy should not be utilized.