Penis and scrotum
Squamous cell carcinoma and variants
Adenosquamous carcinoma


Topic Completed: 1 April 2010

Revised: 13 February 2019

Copyright: 2002-2019, PathologyOutlines.com, Inc.

PubMed Search: Adenosquamous carcinoma penis

Alcides Chaux, M.D.
Antonio L. Cubilla, M.D.
Page views in 2018: 183
Page views in 2019 to date: 184
Cite this page: Chaux A, Cubilla AL. Adenosquamous carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/penscrotumadenosq.html. Accessed September 18th, 2019.
Definition / general
  • Mixed tumor composed of neoplastic squamous nests intermingled with areas of glandular differentiation
  • ICD-0: 8560 / 3
Epidemiology
Sites
  • Most common is glans but extension to coronal sulcus and inner foreskin is also common
Etiology
  • May originate in misplaced glandular cells in perimeatal region, in metaplastic goblet cells of foreskin mucosa or as aberrant differentiation of squamous epithelium
Clinical features
  • Local recurrence in up to 25% and inguinal nodal metastases in 43 - 50% of cases
  • Low mortality rate (0 - 14%)
Case reports
Gross description
  • Firm, gray-white and granular tumor
Gross images

AFIP images

Fig A: deep invasion of lamina propria
and corpus spongiosum;
Fig B: mostly squamous neoplasm (red)
with focal glandular differentiation (green)

Microscopic (histologic) description
  • Squamous cell and glandular patterns, with squamous cell pattern usually predominating
  • Both components are usually discrete but mixtures can be found
  • Glands produce intraluminal and intracellular mucin
  • Frequent presence of penile intraepithelial neoplasia in adjacent mucosa
Microscopic (histologic) images

AFIP images

Infiltrating tumor
has squamous
and glandular
features

Glandular portion is CEA+


Cervix:

Poorly formed glands and squamous components (arrows)



Images hosted on other servers:

Contributed by Alcides Chaux, M.D.
and Antonio Cubilla, M.D.

Nests and differentiation



Cervix:

Malignant glandular (arrow) and squamous components (star)

Positive stains
  • CEA in glandular portion
  • p63 in squamous component
  • 34bE12 in both components
Differential diagnosis
  • Adenosquamous (mucoepidermoid) carcinoma of urethra: ventral in penis, restricted to periurethral tissue and corpus cavernosa
  • Littré gland adenocarcinoma: ventral in penis, restricted to periurethral tissue and corpus cavernosa
  • Metastatic disease: usually involves shaft, tumor emboli present (Int J Surg Pathol 2011;19:597)
  • Mucoepidermoid carcinoma: mixed tumor with mucin but no glandular or ductal structures
  • Pseudoglandular (acantholytic, adenoid) carcinoma: prominent acantholysis simulates glandular spaces but lining is composed of squamous epithelium; spaces contain necrotic debris and keratin, not mucin
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