Penis & scrotum
Squamous cell carcinoma and variants
HPV associated squamous cell carcinoma
Clear cell carcinoma
Authors: Alcides Chaux, M.D., Antonio L. Cubilla, M.D.
Last author update: 1 April 2010
Last staff update: 28 October 2020
Copyright: 2002-2023, PathologyOutlines.com, Inc.
PubMed Search: Clear cell carcinoma penis
Table of Contents
Definition / general | Epidemiology | Sites | Etiology | Clinical features | Case reports | Treatment | Gross description | Microscopic (histologic) description | Positive stains | Differential diagnosisCite this page: Chaux A, Cubilla AL. Clear cell carcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/penscrotumclearcellcarcinoma.html. Accessed May 30th, 2023.
Definition / general
- Recently described aggressive variant of penile carcinoma
Epidemiology
- Middle aged men
Sites
- Foreskin inner mucosa
Etiology
- Most likely of sweat gland origin
- HPV 16 DNA found in all reported cases
Clinical features
- All reported patients presented with inguinal nodal metastases with clear cells and sclerotic basement membrane material
Case reports
- Series of 5 cases of middle aged men is only report to date (Am J Surg Pathol 2004;28:1513)
Treatment
- Excision with wide surgical margin
Gross description
- Large, exophytic and partially ulcerated
- Size 2.5 - 5.5 cm
Microscopic (histologic) description
- Solid proliferation of large neoplastic clear cells
- Marked nuclear atypia
- Extensive geographical necrosis
- Angiolymphatic invasion is common
- Warty PeIN may be found at surface
Positive stains
Differential diagnosis
- Clear cell urothelial carcinoma: previous / concurrent history of urothelial carcinoma elsewhere (Int J Urol 2003;10:348), preferential central location, concurrent areas of urothelial carcinoma in situ and positive for urothelial markers (uroplakin III, thrombomodulin)
- Metastatic renal cell carcinoma: concurrent / previous history of renal carcinoma, deep seated, shaft location, positive for CD10, RCC, PAX2, PAX8 and CA9 (Actas Urol Esp 2005;29:593)
- Sebaceous carcinoma: foreskin outer skin, smaller nuclei, HPV-, PAS- (Arch Pathol Lab Med 2007;131:1655)
- Warty carcinoma: less aggressive behavior, prominent papillae with condylomatous feature, conspicuous koilocytosis, necrosis uncommon, MUC1-
- Well differentiated squamous cell carcinoma with glycogenated ("clear") cells: "clear" glycogenated cells are usually focal and not prominent, retained squamous maturation, pyknotic nuclei, superficially located, MUC1-
