Penis and scrotum
Squamous cell carcinoma and variants
Sarcomatoid carcinoma

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

Revised: 5 April 2018, last major update May 2010

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

PubMed Search: Sarcomatoid carcinoma[TIAB] penis

Cite this page: Cubilla, A., Chaux, A. Sarcomatoid carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/penscrotumsarcomatoid.html. Accessed December 12th, 2018.
Definition / general
Terminology
  • Also called spindle cell carcinoma
  • Rare tumors with distinct sarcoma and carcinoma components are called carcinosarcoma
Epidemiology
  • Median age 59 years (range 28 - 81 years)
Sites
  • Preferred site is glans but extension to coronal sulcus and foreskin is not unusual
Etiology
  • May occur after radiation therapy; low HPV detection rate
Clinical features
  • Represents 1 - 3% of all penile carcinomas (J Urol 2004;172:932)
  • High mortality rate (40 - 75%)
  • Inguinal nodal metastases in 75 - 89% and local recurrence in 67% of all cases
Case reports
Gross description
  • Large gray-white or red polypoid or fungating mass with frequent ulceration and hemorrhage
  • Mean tumor size 3 - 5 cm (up to 7 cm)
  • Cut surface shows deep invasion of corpus spongiosum or corpora cavernosa
  • Superficial or deep tumor satellite nodules
Gross images

Images hosted on PathOut server:
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Polypoid solid mass

Microscopic (histologic) description
  • Predominantly anaplastic spindle cells resembling fibrosarcoma or leiomyosarcoma
  • Occasional giant or multinucleated malignant fibrohistocytoma-like cells
  • Foci of usual squamous cell carcinoma present in most cases
  • Prominent necrosis and mitotic activity
  • Areas of myxoid, chondroid, osteosarcomatous or angiosarcomatous-like changes may be observed
  • Penile intraepithelial neoplasia in adjacent mucosa is not uncommon
Microscopic (histologic) images

Images hosted on PathOut server:

AFIP images:
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Aggregate of rounded
carcinoma cells (top right)
and highly atypical
spindled carcinoma cells


Contributed by Alcides Chaux, M.D. and Antonio Cubilla, M.D.
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Marked nuclear atypia and pleomorphic giant cells

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Resembles angiosarcoma



Images hosted on other servers:


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Biphasic tumor

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Vimentin+


Contributed by Dr. Ajeeth Kumar, Dr. Eliz Thomas, Dr. Karthikeyan, Karpagam Medical College Hospital, India:
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55 year old man with ulcerated lesion on glans penis

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CK10

Positive stains
Negative stains
Differential diagnosis
  • Melanoma: melanin, intraepidermal melanocytic proliferation, nevoid component, positive for S100, MelanA and HMB45, negative for keratin
  • Primary penile sarcoma: usually in penile shaft, no squamous differentiation, no penile intraepithelial neoplasia, negative for p63 and keratin 34bE12