Penis and scrotum
Miscellaneous
Features to report in carcinomas

Author: Shaheed Hakim, M.D. (see Authors page)
Editor: Trevor A. Flood, M.D.

Revised: 6 April 2018, last major update July 2014

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

PubMed Search: Features to report in carcinomas penis

Cite this page: Hakim, S. Features to report in carcinomas. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/penscrotumpenisfeatures.html. Accessed October 18th, 2018.
Definition / general
  • Features to report are according to the College of American Pathologists Cancer Protocols (CAP: Cancer Protocol Templates [Accessed 6 April 2018])
  • Foreskin: presence and type (Am J Surg Pathol 2003;27:994)
    • Uncircumcised
      • Phimosis
    • Circumcised
  • Number of lymph nodes examined and involved
  • Specimen size
  • Tumor site
    • Glans
    • Foreskin (mucosal surface or skin surface)
    • Coronal sulcus
    • Skin of shaft
    • Penile urethra
  • Tumor size (greatest dimension + additional dimensions)
  • Tumor focality
    • Unicentric
    • Multicentric
  • Macroscopic features
    • Flat
    • Ulcerated
    • Polypoid
    • Verruciform
    • Necrosis
    • Hemorrhage
  • Tumor deep borders
    • Pushing
    • Infiltrative
  • Anatomic level of involvement: macroscopic and microscopic
    • Glans
      • Involving subepithelial connective tissue (lamina propria)
      • Involving corpus spongiosum
      • Involving tunica albuginea
      • Involving corpus cavernosum
      • Involving distal (penile) urethra
    • Foreskin
      • Involving subepithelial connective tissue (lamina propria)
      • Involving tunica albuginea
      • Involving corpus cavernosum
      • Involving distal (penile) urethra
    • Shaft
      • Involves skin
      • Involves dartos
      • Involves Buck fascia
      • Involves corpus spongiosum
      • Involves corpus cavernosum
      • Involves proximal urethra
  • Gross assessment of surgical resection margins
  • Tumor type (invasive, noninvasive, in situ)
  • Histological type
    • Squamous cell carcinoma
      • Usual
      • Basaloid
      • Warty
      • Verrucous
      • Cuniculatum
      • Sarcomatoid
      • Pseudohyperplastic
      • Acantholytic
      • Mixed SCCs
      • Adenosquamous
    • Primary neuroendocrine carcinoma
    • Paget disease
    • Adnexal carcinoma
    • Clear cell carcinoma
    • Carcinoma, NOS
  • Histological grade
    • Well differentiated (G1)
    • Moderately differentiated (G2)
    • Poorly differentiated (G3); % present (J Urol 2001;165:1138)
  • Tumor thickness
  • Lymph - vascular invasion
  • Perineural invasion
  • Presence of associated lesions
    • Squamous hyperplasia
    • PeIN (differentiated, basaloid, warty, warty basaloid)
    • Lichen sclerosus
  • Depth of invasion (Mod Pathol 2001;14:963)
    • From deepest malignant cell to highest overlying dermal papilla
    • Note: if tumor replaces most of penis, measure tumor thickness from nonkeratinized tumor surface to deepest point of invasion
  • Prognostic index optional (Am J Surg Pathol 2009;33:1049)
Diagrams / tables

Images hosted on PathOut server:
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Possible sites of involvement

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Periurethral corpus spongiosum involvement

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Tumor involvement in yellow

Microscopic (histologic) images

Images hosted on PathOut server:
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Lamina propria
invasion with sparing
of the corpus
spongiosum (left)

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Urethral mucosal involvement



Images hosted on other servers:
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Grade 1

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Grade 2, more disorganized growth

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Grade 3