Squamous cell carcinoma of the penis

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Squamous cell carcinoma of the penis
Diagnosis in short

Squamous carcinoma of the penis. H&E stain.
LM DDx penile intraepithelial neoplasia, pseudoepitheliomatous hyperplasia
Gross mass lesion, scaly patches/nodules, usu. erythematous, +/-ulceration.
Grossing notes penectomy
Site penis

Clinical history uncircumcised
Prevalence uncommon overall, most common form of penis cancer
Prognosis good
Treatment surgery

Squamous cell carcinoma of the penis is the most common malignancy of the penis.

Penile cancer redirects to this article.

General

  • Not very common overall.[1]
  • Most common form of penile cancer.
    • Non-squamous penis cancer only ~5% of cases.[2]

Epidemiology:[1]

  • Median age ~ 67 years old.
  • Usually a good outcome - 5 year cause specific survival ~ 81%.[1]
  • Possible association with sex with animals.[3]

Gross

  • Scaly patches/nodules.
  • Usually erythematous.
  • +/-Ulceration.

Microscopic

Features:

Notes:

DDx:

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:

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

IHC

  • p16 +ve - in types associated with HPV (basaloid SCC, warty SCC and warty-basaloid SCC).[5]

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Biopsy

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.

Resection

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.

All caps

TIP OF PENIS, PARTIAL PENECTOMY:
- INVASIVE SQUAMOUS CELL CARCINOMA, MODERATELY DIFFERENTIATED.
-- SURGICAL MARGINS NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.
-- PLEASE SEE TUMOUR SUMMARY.
TIP OF PENIS, PARTIAL PENECTOMY:
- INVASIVE SQUAMOUS CELL CARCINOMA OF CORONAL SULCUS, MODERATELY DIFFERENTIATED.
-- SURGICAL MARGINS NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.
- LICHEN SCLEROSIS.
- POST-SURGICAL CHANGES (GRANULOMATOUS INFLAMMATION (NON-NECROTIZING), SIDEROPHAGES).

COMMENT:
This lesion was previously excised. The surgical clearance is 1 mm. The tumour 
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.

See also

References

  1. 1.0 1.1 1.2 1.3 Burt, LM.; Shrieve, DC.; Tward, JD. (Jan 2014). "Stage presentation, care patterns, and treatment outcomes for squamous cell carcinoma of the penis.". Int J Radiat Oncol Biol Phys 88 (1): 94-100. doi:10.1016/j.ijrobp.2013.08.013. PMID 24119832.
  2. Moses, KA.; Sfakianos, JP.; Winer, A.; Bernstein, M.; Russo, P.; Dalbagni, G. (Dec 2013). "Non-squamous cell carcinoma of the penis: single-center, 15-year experience.". World J Urol. doi:10.1007/s00345-013-1216-y. PMID 24292119.
  3. Zequi, Sde C.; Guimarães, GC.; da Fonseca, FP.; Ferreira, U.; de Matheus, WE.; Reis, LO.; Aita, GA.; Glina, S. et al. (Jul 2012). "Sex with animals (SWA): behavioral characteristics and possible association with penile cancer. A multicenter study.". J Sex Med 9 (7): 1860-7. doi:10.1111/j.1743-6109.2011.02512.x. PMID 22023719.
  4. Bhagat, SK.; Gopalakrishnan, G.; Kekre, NS.; Chacko, NK.; Kumar, S.; Manipadam, MT.; Samuel, P. (Feb 2010). "Factors predicting inguinal node metastasis in squamous cell cancer of penis.". World J Urol 28 (1): 93-8. doi:10.1007/s00345-009-0421-1. PMID 19488760.
  5. Cubilla, AL.; Lloveras, B.; Alemany, L.; Alejo, M.; Vidal, A.; Kasamatsu, E.; Clavero, O.; Alvarado-Cabrero, I. et al. (Jun 2012). "Basaloid squamous cell carcinoma of the penis with papillary features: a clinicopathologic study of 12 cases.". Am J Surg Pathol 36 (6): 869-75. doi:10.1097/PAS.0b013e318249c6f3. PMID 22367299.