Penis and scrotum
Squamous cell carcinoma and variants
Adenosquamous carcinoma

Authors: Antonio Cubilla, M.D., Alcides Chaux, M.D. (see Authors page)

Revised: 4 April 2018, last major update April 2010

Copyright: (c) 2002-2018, PathologyOutlines.com, Inc.

PubMed Search: Adenosquamous carcinoma penis

Cite this page: Cubilla, A., Chaux, A. Adenosquamous carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/penscrotumadenosq.html. Accessed July 21st, 2018.
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
Diagrams / tables

Images hosted on PathOut server:

Fig B: mostly squamous
neoplasm (red) with
focal glandular
differentiation (green)

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

Images hosted on PathOut server:

Fig A: deep invasion
of lamina propria
and corpus
spongiosum

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

Images hosted on PathOut server:

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