Penis & scrotum

Squamous cell carcinoma and variants

Adenosquamous carcinoma



Topic Completed: 1 April 2010

Minor changes: 7 January 2021

Copyright: 2002-2021, PathologyOutlines.com, Inc.

PubMed Search: Adenosquamous carcinoma penis

Alcides Chaux, M.D.
Antonio L. Cubilla, M.D.
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Cite this page: Chaux A, Cubilla AL. Adenosquamous carcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/penscrotumadenosq.html. Accessed October 28th, 2021.
Definition / general
  • Mixed tumor composed of neoplastic squamous nests intermingled with areas of glandular differentiation
  • ICD-0: 8560 / 3
Epidemiology
Sites
  • Most common is glans but extension to coronal sulcus and inner foreskin is also common
Etiology
  • May originate in misplaced glandular cells in perimeatal region, in metaplastic goblet cells of foreskin mucosa or as aberrant differentiation of squamous epithelium
Clinical features
  • Local recurrence in up to 25% and inguinal nodal metastases in 43 - 50% of cases
  • Low mortality rate (0 - 14%)
Case reports
Gross description
  • Firm, gray-white and granular tumor
Gross images

AFIP images

Various images

Microscopic (histologic) description
  • Squamous cell and glandular patterns, with squamous cell pattern usually predominating
  • Both components are usually discrete but mixtures can be found
  • Glands produce intraluminal and intracellular mucin
  • Frequent presence of penile intraepithelial neoplasia in adjacent mucosa
Microscopic (histologic) images

Contributed by Alcides Chaux, M.D. and Antonio Cubilla, M.D.
Nests and differentiation

Nests and differentiation



AFIP images

Infiltrating tumor
has squamous
and glandular
features

Glandular portion is CEA+

Cervix: poorly formed glands and squamous components (arrows)



Images hosted on other servers:

Cervix: malignant glandular (arrow) and squamous components (star)

Positive stains
  • CEA in glandular portion
  • p63 in squamous component
  • 34bE12 in both components
Differential diagnosis
  • Adenosquamous (mucoepidermoid) carcinoma of urethra: ventral in penis, restricted to periurethral tissue and corpus cavernosa
  • Littré gland adenocarcinoma: ventral in penis, restricted to periurethral tissue and corpus cavernosa
  • Metastatic disease: usually involves shaft, tumor emboli present (Int J Surg Pathol 2011;19:597)
  • Mucoepidermoid carcinoma: mixed tumor with mucin but no glandular or ductal structures
  • Pseudoglandular (acantholytic, adenoid) carcinoma: prominent acantholysis simulates glandular spaces but lining is composed of squamous epithelium; spaces contain necrotic debris and keratin, not mucin
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