Table of Contents
Definition / general | Terminology | Epidemiology | Sites | Etiology | Clinical features | Case reports | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Differential diagnosisCite this page: Chaux A, Cubilla AL. Squamous cell carcinoma, NOS. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/penscrotumSCC.html. Accessed January 18th, 2021.
Definition / general
- NOS: not otherwise specified; i.e. usual histologic pattern
- Represents 48 - 65% of all penile squamous cell carcinomas (Anal Quant Cytol Histol 2007;29:185)
- ICD-O: 8070 / 3
Terminology
- Also called usual, typical, conventional, classical or epidermoid squamous cell carcinoma
Epidemiology
- Mean age 58 years
Sites
- Glans is the preferred site but extension to coronal sulcus and inner foreskin is common
Etiology
- 25% of cases are HPV+ (Am J Surg Pathol 2010;34:104)
Clinical features
- Inguinal nodal metastases in 28 - 39% and recurrences in 28% of all cases
- Intermediate mortality rate (20 - 38%)
Case reports
- 66 year old man with metastatic disease in pleural effusion (Arch Pathol Lab Med 1992;116:198)
Gross description
- Predominant growth patterns are vertical and superficial spreading
- Gross aspect is nondistinctive and variable
- Mean tumor size varies from 2 cm in low incidence areas to 4 - 5 cm in high incidence areas
- Cut surface shows tan-white solid irregular tumor with superficial or deep penetration
Gross images
Microscopic (histologic) description
- Usually keratinized with moderate differentiation
- Up to 50% of cases are heterogeneous (more than one histological grade)
- Most cases have differentiated penile intraepithelial neoplasia and squamous hyperplasia
- Tumors composed exclusively of extremely well differentiated or poorly differentiated areas are uncommon
- In some cases clear glycogenated cells may predominate (but must differentiate from koilocytes)
- Stroma has variable lymphoplasmacytic infiltrate
- Foreign body type giant cells often seen in highly keratinized tumors
Microscopic (histologic) images
Contributed by Alcides Chaux, M.D. and Antonio Cubilla, M.D.



Usual type: well differentiated (left, grade 1); moderately differentiated (middle, grade 2); poorly differentiated (right, grade 3)
AFIP images
Differential diagnosis
- Basaloid carcinoma: basophilic cytoplasm, indistinctive cellular borders and mostly HPV+
- Clear cell carcinoma: exclusively composed of high grade large polygonal cells with clear PAS+ cytoplasm, extensive areas of geographical necrosis and HPV+
- Pseudoepitheliomatous hyperplasia: elongated rete ridges, no nuclear atypia, regular epithelial nests with evident peripheral palisading and no stromal reaction
- Urothelial carcinoma: ventral surface of penis, absence of squamous metaplasia, microglandular hyperplasia, lichen sclerosus or penile intraepithelial neoplasia, presence of urothelial carcinoma in situ or history of urothelial CIS or bladder tumor