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Penis and scrotum
Miscellaneous
Features to report in carcinomas
Editor: Antonio Cubilla, M.D. and Alcides Chaux, M.D. (see Author/Reviewers page)
Revised: 25 May 2010, last major update May 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
Features to Report
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● Tumor site (glans, coronal sulcus, foreskin, skin of shaft or combination)
● Largest tumor size
● Histologic type (squamous cell carcinoma of usual type, adenosquamous, basaloid, cuniculatum, mixed, papillary, pseudoglandular, pseudohyperplastic, sarcomatoid, unclassified, verrucous, warty, warty-basaloid)
● Growth pattern (superficial spreading, vertical growth, verruciform, multicentric)
● Histopathologic grade (well, moderately, poorly differentiated (possibly the %, J Urol 2001;165:1138) or undifferentiated)
● Anatomic level of invasion: lamina propria, dartos skin in foreskin, lamina propria, corpus spongiosum, tunica albuginea and corpora cavernosa
● Presence of perineural invasion
● Presence of vascular invasion
● Margin of resection involvement: skin of shaft, corpora cavernosa, urethral epithelium and surrounding tissues (lamina propria, corpus spongiosum, tunica albuginea, penile fascia)
● Depth of invasion from deepest malignant cell to highest overlying dermal papilla (micro image)
● Note: if tumor replaces most of penis, measure tumor thickness from non-keratinized tumor surface to deepest point of invasion
● Presence of associated lesions: squamous hyperplasia, PeIN (differentiated, basaloid, warty, warty-basaloid), lichen sclerosus
● Prognostic Index (optional, Am J Surg Pathol 2009;33:1049)
Gross images
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Penile carcinoma that has been transversely sectioned at intervals shows differing depths of invasion of crucial anatomic compartments. Note involvement of corpora cavernosa (central two slices), urethra and periurethral corpus spongiosum (top), and Buck’s fascia (top and bottom).
Diagrammatic representation of possible sites of involvement. The purple dots indicate the usual sites of positive margins (u-urethra, lp-lamina propria, cs-corpus spongiosum, bf-Buck’s fascia).
A: Diagrammatic representation of periurethral corpus spongiosum involvement by carcinoma (ca-yellow, u-urethra, cc-corpus cavernosa, fas-Buck’s fascia).
B: Squamous cell carcinoma involves the corpora cavernosa, with the left more involved than the right. The urethra (bottom) is uninvolved.
C: Diagram of B showing tumor involvement in yellow (ca-carcinoma, a-tunica albuginea, cc-corpus cavernosum, cs-corpus spongiosum, u-urethra).
There is extensive involvement by carcinoma, including Buck’s fascia, at the resection margin (top right). This is seen diagrammatically in this figure (top right). (bf-Buck’s fascia, f-foreskin, lp-lamina propria, cs-corpus spongiosum, cc-corpus cavernosum).
Micro images
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Lamina propria invasion with sparing Urethral mucosal involvement
of the corpus spongiosum (left).
Additional references
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End of Penis and scrotum > Miscellaneous > Features to report in carcinomas
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