Penis & scrotum
Squamous cell carcinoma and variants
HPV independent squamous cell carcinoma
Sarcomatoid carcinoma
Authors: Alcides Chaux, M.D., Antonio L. Cubilla, M.D.
Last author update: 1 May 2010
Last staff update: 28 October 2020
Copyright: 2002-2023, PathologyOutlines.com, Inc.
PubMed Search: Sarcomatoid carcinoma[TIAB] penis
Table of Contents
Definition / general | Terminology | Epidemiology | Sites | Etiology | Clinical features | Case reports | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Differential diagnosisCite this page: Chaux A, Cubilla AL. Sarcomatoid carcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/penscrotumsarcomatoid.html. Accessed June 1st, 2023.
Definition / general
- Aggressive variant of penile squamous cell carcinomas composed mostly of anaplastic spindle cells (Am J Surg Pathol 2005;29:1152)
- ICD-O: 8074 / 3
Terminology
- Also called spindle cell carcinoma
- Rare tumors with distinct sarcoma and carcinoma components are called carcinosarcoma
Epidemiology
- Median age 59 years (range 28 - 81 years)
Sites
- Preferred site is glans but extension to coronal sulcus and foreskin is not unusual
Etiology
- May occur after radiation therapy; low HPV detection rate
Clinical features
- Represents 1 - 3% of all penile carcinomas (J Urol 2004;172:932)
- High mortality rate (40 - 75%)
- Inguinal nodal metastases in 75 - 89% and local recurrence in 67% of all cases
Case reports
- 50 year old man with 3 cm tumor of glans (Indian J Urol 2008;24:267)
Gross description
- Large gray-white or red polypoid or fungating mass with frequent ulceration and hemorrhage
- Mean tumor size 3 - 5 cm (up to 7 cm)
- Cut surface shows deep invasion of corpus spongiosum or corpora cavernosa
- Superficial or deep tumor satellite nodules
Gross images
AFIP images
Polypoid solid mass
Microscopic (histologic) description
- Predominantly anaplastic spindle cells resembling fibrosarcoma or leiomyosarcoma
- Occasional giant or multinucleated malignant fibrohistocytoma-like cells
- Foci of usual squamous cell carcinoma present in most cases
- Prominent necrosis and mitotic activity
- Areas of myxoid, chondroid, osteosarcomatous or angiosarcomatous-like changes may be observed
- Penile intraepithelial neoplasia in adjacent mucosa is not uncommon
Microscopic (histologic) images
Contributed by Alcides Chaux, M.D. and Antonio Cubilla, M.D.
Marked nuclear atypia and pleomorphic giant cells
Resembles angiosarcoma
Contributed by Ajeeth Kumar, M.D., Dr. Eliz Thomas and Mythreye Karthikeyan, Ph.D.
55 year old man with ulcerated lesion on glans penis
CK10
AFIP images
Aggregate of rounded
carcinoma cells (top right)
and highly atypical
spindled carcinoma cells
Images hosted on other servers:
Biphasic tumor
Vimentin+
Positive stains
Negative stains
Differential diagnosis
