Penis and scrotum
Squamous cell carcinoma and variants
Reviewers: Antonio Cubilla, M.D. and Alcides Chaux, M.D. (see Author/Reviewers page)
Revised: 27 May 2010, last major update May 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
● Penile exophytic tumors with verruciform gross appearance and low/intermediate grade papillomatous features
● Either condylomatous (giant condyloma, warty carcinoma) or non-condylomatous (verrucous carcinoma, papillary NOS carcinoma, carcinoma cuniculatum)
● Variable incidence of HPV infection
● Low incidence of regional metastasis and better outcome than usual carcinoma
● Biopsies may be unable to determine histologic type (Int J Surg Pathol 2004;12:139)
Gross description (Macroscopy)
● Usually large tumors with a cauliflower-like aspect
● May present a predominant exophytic or a mixed exophytic-endophytic pattern of growth
Micro description (Histopathology)
● Papillae with mild to marked acanthosis
● Hyperkeratosis and parakeratosis
● May have prominent, irregular or inconspicuous fibrovascular cores
● Variable HPV-related cytopathic changes (koilocytosis)
● Tumor front may be broad-based or jagged
● Stromal reaction is usually evident
A: Verrucous carcinoma: regular papillae with broad bulbous bases and prominent hyperkeratosis (red). Keratinized cysts are present (seen on cross section at base).
B: Papillary carcinoma, not otherwise specified: papillae are more irregular than in A, many with fibrovascular cores. Infiltration is present at the base and koilocytosis is absent.
C: Giant condyloma: arborescent hyperkeratotic papillae with broad bases and koilocytosis (indicated by the white dots) at the surface.
D: Warty (condylomatous) carcinoma: papillae are more irregular than in C, koilocytosis is diffuse, and the interface between tumor and stroma is irregular.
End of Penis and scrotum > Squamous cell carcinoma and variants > Verruciform carcinoma
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