Penis and scrotum - Pseudoglandular

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Penis and scrotum

Squamous cell carcinoma and variants

Pseudoglandular carcinoma

Editor: Antonio Cubilla, M.D. and Alcides Chaux, M.D. (see Author/Reviewers page)

Revised: 13 May 2010, last major update April 2010

Definition

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● Unusual and aggressive variant of penile carcinoma with pseudoglands, often filled with amorphous material

Terminology

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● Also called adenoid or acantholytic carcinoma

Epidemiology

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● Average 54 years

Sites

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● Glans, coronal sulcus and inner foreskin are usually involved

Clinical features

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● Higher metastatic rate and cancer-related deaths when compared with usual SCC

Case reports

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● Series of 7 cases (Am J Surg Pathol 2009;33:551)

Gross description (Macroscopy)

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● Large, irregular white-gray ulcerative or exophytic masses

● Frequent invasion of deep erectile tissues

● Average size 4.6 cm

Micro description (Histopathology)

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● Hallmark is the pseudogland: open space lined by atypical, cubical or cylindrical uni-or multi-stratified cells

● Pseudoglands frequently filled with amorphous material containing debris, keratin and desquamated cells

● Intraluminal neutrophilic microabscesses are not uncommon

● Frequent presence of intracytoplasmic clear vacuoles, sometimes with a collaret arrangement

● Variegated tumor aspect showing solid areas intermingled with pseudoglandular spaces

● Frequent vascular and perineural invasion

Micro images

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Contributed by Dr. Alcides Chaux and Dr. Antonio Cubilla:

Deeply infiltrative solid tumor nests with Irregular tumor nests, some showing open

extensive central acantholysis simulating spaces corresponding to pseudolumina

glandular lumina; note the prominent filled with necrotic debris and

stromal reaction eosinophilic material

Penis:

Conjunctiva:

Pseudoglandular pattern due to acantholysis of neoplastic squamous cells

Head and neck:

Pseudolumina are present, but no true glands

Skin:

Various images

Vulva:

Negative stains

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● Factor VIII, PAS, Alcian blue

Differential Diagnosis

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● Adenocarcinoma of Littré glands: true glandular differentiation, ventrally located with secondary extension to perimeatal area

● Adenosquamous carcinoma: true glandular lining, more homogeneous, squamous areas predominate, negative for CEA and mucin stains

● Pseudoangiosarcomatoid variant of sarcomatoid carcinoma: alveolar and not pseudoglandular pattern of growth, more typical areas of sarcomatoid carcinoma elsewhere, negative for CEA and mucin stains

● Urothelial carcinoma of distal urethra with glandular features: previous/concurrent history of urothelial carcinoma elsewhere, presence of urothelial carcinoma in situ, positive for urothelial markers (uroplakin-III, thrombomodulin)

End of Penis and scrotum > Squamous cell carcinoma and variants > Pseudoglandular carcinoma

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