GCBL has been treated by several modalities, which can be classified into three types: topical therapy (e.g., podophyllin, fluorouracil or radiotherapy), tumor removal (e.g., cryotherapy, CO2 laser therapy or surgical excision) and immunotherapy (e.g., imiquimod). However, the variety of treatment regimens currently applied does not allow the formulation of definitive therapeutic guidelines. The application of imiquimod (5%), podophyllin (25–30%), trichloroacetic acid, 5-fluorouracil and bleomycin alone or combined with cisplatin or methotrexate has had variable results. Treatment with interferons 2α and 2β combined with laser therapy (Nd:YAG) has been described, as well as cryosurgery with some cases of success. Radical surgical excision with wide surgical margins remains the first line of treatment, with a higher success rate (63–91%) and a lower rate of relapse . Nevertheless, penile skin loss and repair of the urethra can be a challenge for urologists. Surgical options include one-stage or two-stage procedures, using either single or multiple tissue transfer [9, 10]. Preputial and various penile skin flaps, such as a longitudinal flap, the hockey stick flap, the penile island flap and the circumferential/circumpenile flap, have been used for penile urethral reconstruction as good options when needed [11, 12]. A large representative biopsy specimen is important to judge the structure of the lesion in order to establish the diagnosis and to exclude VC . In microscopic examination, invasion of the subepithelial tissue is seen by expansion rather than by infiltration, leaving the basement membrane intact. A well-stratified epithelium is shown with minimal cellular dysplasia or atypical cells, rare mitotic figures, acanthosis and hyperkeratosis and no evidence of neural or vascular invasion . The risk of recurrence after excision is 60–66%, with an overall mortality of 20–30% . Close follow-up of these patients is crucial given the complexity and tumor recurrence.