Squamous cell carcinoma of the penis: Difference between revisions

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{{ Infobox diagnosis
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Name      = {{PAGENAME}}
| Image      =  
| Image      = Squamous carcinoma of the penis -- low mag.jpg
| Width      =
| Width      =
| Caption    =  
| Caption    = Squamous carcinoma of the penis. [[H&E stain]].
| Synonyms  =
| Synonyms  =
| Micro      =
| Micro      =
| Subtypes  =
| Subtypes  = HPV-related SCC, Non-HPV-related SCC
| LMDDx      =
| LMDDx      = [[penile intraepithelial neoplasia]], [[pseudoepitheliomatous hyperplasia]]
| Stains    =
| Stains    =
| IHC        =
| IHC        =
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| IF        =
| IF        =
| Gross      = mass lesion, scaly patches/nodules, usu. erythematous, +/-ulceration.
| Gross      = mass lesion, scaly patches/nodules, usu. erythematous, +/-ulceration.
| Grossing  =
| Grossing  = [[penectomy]]
| Site      = [[penis]]
| Site      = [[penis]]
| Assdx      =
| Assdx      =
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}}
}}
'''Squamous cell carcinoma of the penis''' is the most common malignancy of the [[penis]].
'''Squamous cell carcinoma of the penis''' is the most common malignancy of the [[penis]].
''Penile cancer'' redirects to this article.


==General==
==General==
*Not very common overall.<ref name=pmid24119832>{{Cite journal  | last1 = Burt | first1 = LM. | last2 = Shrieve | first2 = DC. | last3 = Tward | first3 = JD. | title = Stage presentation, care patterns, and treatment outcomes for squamous cell carcinoma of the penis. | journal = Int J Radiat Oncol Biol Phys | volume = 88 | issue = 1 | pages = 94-100 | month = Jan | year = 2014 | doi = 10.1016/j.ijrobp.2013.08.013 | PMID = 24119832 }}</ref>
*Not very common overall.<ref name=pmid24119832>{{Cite journal  | last1 = Burt | first1 = LM. | last2 = Shrieve | first2 = DC. | last3 = Tward | first3 = JD. | title = Stage presentation, care patterns, and treatment outcomes for squamous cell carcinoma of the penis. | journal = Int J Radiat Oncol Biol Phys | volume = 88 | issue = 1 | pages = 94-100 | month = Jan | year = 2014 | doi = 10.1016/j.ijrobp.2013.08.013 | PMID = 24119832 }}</ref>
*Most common form of penis cancer.
*Most common form of penile cancer.
**Non-squamous penis cancer only ~5% of cases.<ref name=pmid24292119>{{Cite journal  | last1 = Moses | first1 = KA. | last2 = Sfakianos | first2 = JP. | last3 = Winer | first3 = A. | last4 = Bernstein | first4 = M. | last5 = Russo | first5 = P. | last6 = Dalbagni | first6 = G. | title = Non-squamous cell carcinoma of the penis: single-center, 15-year experience. | journal = World J Urol | volume =  | issue =  | pages =  | month = Dec | year = 2013 | doi = 10.1007/s00345-013-1216-y | PMID = 24292119 }}</ref>
**Non-squamous penis cancer only ~5% of cases.<ref name=pmid24292119>{{Cite journal  | last1 = Moses | first1 = KA. | last2 = Sfakianos | first2 = JP. | last3 = Winer | first3 = A. | last4 = Bernstein | first4 = M. | last5 = Russo | first5 = P. | last6 = Dalbagni | first6 = G. | title = Non-squamous cell carcinoma of the penis: single-center, 15-year experience. | journal = World J Urol | volume =  | issue =  | pages =  | month = Dec | year = 2013 | doi = 10.1007/s00345-013-1216-y | PMID = 24292119 }}</ref>


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*Median age ~ 67 years old.
*Median age ~ 67 years old.
*Usually a good outcome - 5 year cause specific survival ~ 81%.<ref name=pmid24119832/>
*Usually a good outcome - 5 year cause specific survival ~ 81%.<ref name=pmid24119832/>
*Possible association with sex with animals.<ref>{{Cite journal  | last1 = Zequi | first1 = Sde C. | last2 = Guimarães | first2 = GC. | last3 = da Fonseca | first3 = FP. | last4 = Ferreira | first4 = U. | last5 = de Matheus | first5 = WE. | last6 = Reis | first6 = LO. | last7 = Aita | first7 = GA. | last8 = Glina | first8 = S. | last9 = Fanni | first9 = VS. | title = Sex with animals (SWA): behavioral characteristics and possible association with penile cancer. A multicenter study. | journal = J Sex Med | volume = 9 | issue = 7 | pages = 1860-7 | month = Jul | year = 2012 | doi = 10.1111/j.1743-6109.2011.02512.x | PMID = 22023719 }}</ref>


==Gross==
==Gross==
*Scaly patches/nodules.
*Scaly patches/nodules.
*Usu. erythematous.
*Usually erythematous.
*+/-Ulceration.
*+/-Ulceration.


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Notes:
Notes:
*Usually grade 2.<ref name=pmid24119832/>
*[[Lymphovascular invasion]] - prognostically important,<ref name=pmid19488760>{{Cite journal  | last1 = Bhagat | first1 = SK. | last2 = Gopalakrishnan | first2 = G. | last3 = Kekre | first3 = NS. | last4 = Chacko | first4 = NK. | last5 = Kumar | first5 = S. | last6 = Manipadam | first6 = MT. | last7 = Samuel | first7 = P. | title = Factors predicting inguinal node metastasis in squamous cell cancer of penis. | journal = World J Urol | volume = 28 | issue = 1 | pages = 93-8 | month = Feb | year = 2010 | doi = 10.1007/s00345-009-0421-1 | PMID = 19488760 }}</ref> and changes the T-stage for pT1a tumours to pT1b.
 
DDx:
*[[Penile intraepithelial neoplasia]] (squamous dysplasia).
*[[Pseudoepitheliomatous hyperplasia]].
 
===Subtyping===
*''Non-HPV-related squamous cell carcinoma.
**p16 -ve, p53 +ve.{{fact}}
*''HPV-related squamous cell carcinoma''.
**p16 +ve, p53 -ve.{{fact}}
 
===Grading===
*G1 - well differentiated. §
**Almost normal appearing - diagnosis of malignancy may be challenging.
*G2 - moderately differentiated. §
*G3 - poorly differentiated.
**Anaplastic cells.
**Typically little or no keratinization.
*GX - cannot be assessed.
 
Notes:
*§ The differentiation between G1 and G2 is similar to [[squamous cell carcinoma of the head and neck]].
*G2 (moderately differentiated) is the most common.<ref name=pmid24119832/>
 
===Staging===
T-stage:
*pT1a - subepithelial tissue involved, no [[LVI]], not poorly differentiated (G3).
*pT1b - subepithelial tissue involved with [[LVI]] ''or'' poorly differentiated.
*pT2 - corpus spongiosum or cavernosum involved.
*pT3 - urethral involvement.
*pT4 - adjacent structure(s) involved.
 
===Images===
<gallery>
Image: Squamous carcinoma of the penis -- low mag.jpg | Penile SCC - low mag.
Image: Squamous carcinoma of the penis -- high mag.jpg | Penile SCC - high mag.
Image: Squamous carcinoma of the penis - alt -- high mag.jpg | Penile SCC - high mag.
Image: Squamous carcinoma of the penis - 2 -- intermed mag.jpg | Penile SCC - intermed. mag.
Image: Squamous carcinoma of the penis - 2 -- high mag.jpg | Penile SCC - high mag.
</gallery>
 
==IHC==
*p16 +ve - in types associated with [[HPV]] (basaloid SCC, warty SCC and warty-basaloid SCC).<ref name=pmid22367299>{{Cite journal  | last1 = Cubilla | first1 = AL. | last2 = Lloveras | first2 = B. | last3 = Alemany | first3 = L. | last4 = Alejo | first4 = M. | last5 = Vidal | first5 = A. | last6 = Kasamatsu | first6 = E. | last7 = Clavero | first7 = O. | last8 = Alvarado-Cabrero | first8 = I. | last9 = Lynch | first9 = C. | title = Basaloid squamous cell carcinoma of the penis with papillary features: a clinicopathologic study of 12 cases. | journal = Am J Surg Pathol | volume = 36 | issue = 6 | pages = 869-75 | month = Jun | year = 2012 | doi = 10.1097/PAS.0b013e318249c6f3 | PMID = 22367299 }}</ref>


==Sign out==
==Sign out==
===Biopsy===
<pre>
Penis, Biopsy:
- INVASIVE SQUAMOUS CELL CARCINOMA, well differentiated.
Comment:
The tumour has differentiated penile intraepithelial neoplasia adjacent to it. The tumour is p16 negative and p53 positive.
</pre>
===Resection===
<pre>
Tip of Penis, Partial Penectomy:
- Invasive squamous cell carcinoma, moderately differentiated (G2).
-- Invasion into the lamina propria.
-- Surgical margins negative for dysplasia and negative for malignancy.
-- TNM stage: pT1a pNx.
-- Please see tumour summary.
</pre>
===All caps===
<pre>
<pre>
TIP OF PENIS, PARTIAL PENECTOMY:
TIP OF PENIS, PARTIAL PENECTOMY:
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COMMENT:
COMMENT:
This lesion was previously excised. The surgical clearance is 1 mm. The tumour  
This lesion was previously excised. The surgical clearance is 1 mm. The tumour  
thickness is approximately 4 mm.
thickness is approximately 4 mm. No lymphovascular invasion is identified. No
lymphovascular invasion is identified. No corpus spongiosum or corpus cavernosum
invasion is seen. The staging is unchanged.
</pre>
</pre>
===Micro===
The sections show a malignant tumour with moderate to severe anisonucleosis. It focally underlies keratinizing epithelium that matures to the surface. Intracellular bridges are present focally. Keratinization is present.  Mitotic activity is easily identified.


==See also==
==See also==
Retrieved from "https://librepathology.org/wiki/Squamous_cell_carcinoma_of_the_penis"