Penile cancer is a rare neoplasm and its exact carcinogenesis is not entirely understood. Several risk factors are known and a link between human papillomavirus (HPV) and penile cancer has been clearly shown. In order to give the best treatment to the patients, it is exceedingly important to recognize precursor lesions, which are numerous and complex, and make the right diagnosis. There are many different variants of penile squamous cell carcinoma with different prognosis. Given the rarity of these lesions, central pathological review could be an appropriate option.