Grossing penectomy specimens

Penis and scrotum
Miscellaneous
Grossing penectomy specimens

Authors: Shaheed W. Hakim, M.D., Trevor A. Flood, M.D.

Topic Completed: 1 June 2014

Minor changes: 13 December 2019

Copyright: 2002-2019, PathologyOutlines.com, Inc.

PubMed Search: Gross penectomy

Page views in 2019: 1,630

Page views in 2020 to date: 542

Table of Contents

Procedure | Diagrams / tables | Gross images | Additional references

Cite this page: Hakim SW, Flood TA. Grossing penectomy specimens. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/penscrotumgrossingpenect.html. Accessed May 30th, 2020.

Procedure

In the fresh state, cut the proximal resection margin en face
Three important areas of the resection margin need to sampled:
1. Proximal urethra and surrounding periurethral cylinder composed of epithelium, subepithelial connective tissue (lamina propria), corpus spongiosum and penile fascia
  - The urethra may be retracted but it is important to locate it and submit its circumference entirely
2. Corpora cavernosa separated and surrounded by tunica albuginea and Buck fascia
3. Skin of shaft with underlying corporal dartos
Fix the remaining specimen in 10% buffered formalin overnight
After fixation, section the glans and shaft longitudinally (sagitally) in two halves, using the meatus and anterior urethra as a guide
Do NOT probe the urethra as doing so can result in distortion of the urethral mucosa
If foreskin is present:
- Measure its length and identify the presence / absence of phimosis
- If not affected by tumor, separate the foreskin leaving a 3 mm margin from the coronal sulcus and include it as a circumcision specimen
Do NOT remove foreskin if it is affected by tumor
Document the tumor size, location, color, growth pattern and distance from resection margin
Take a photograph of the specimen showing the maximum tumor depth of invasion
Map the photograph according to sections submitted
Section each half longitudinally along the specimens' longest axis, at 3 to 5 mm intervals
Submit entirely the section which depicts the deepest anatomical level infiltrated by tumor
If tumor affects multiple anatomical compartments, submit at least three sections of each compartment affected
Sections should always attempt to include adjacent nontumoral mucosa