Penis & scrotum

Squamous cell carcinoma and variants

HPV independent squamous cell carcinoma

Sarcomatoid carcinoma

Last author update: 1 May 2010
Last staff update: 28 October 2020

Copyright: 2002-2023,, Inc.

PubMed Search: Sarcomatoid carcinoma[TIAB] penis

Alcides Chaux, M.D.
Antonio L. Cubilla, M.D.
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Cite this page: Chaux A, Cubilla AL. Sarcomatoid carcinoma. website. Accessed June 1st, 2023.
Definition / general
  • Also called spindle cell carcinoma
  • Rare tumors with distinct sarcoma and carcinoma components are called carcinosarcoma
  • Median age 59 years (range 28 - 81 years)
  • Preferred site is glans but extension to coronal sulcus and foreskin is not unusual
  • 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
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
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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.
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Marked nuclear atypia and pleomorphic giant cells

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Resembles angiosarcoma

Contributed by Ajeeth Kumar, M.D., Dr. Eliz Thomas and Mythreye Karthikeyan, Ph.D.
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55 year old man with ulcerated lesion on glans penis

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AFIP images
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Aggregate of rounded
carcinoma cells (top right)
and highly atypical
spindled carcinoma cells

Images hosted on other servers:
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Biphasic tumor

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Positive stains
Negative stains
Differential diagnosis
  • Melanoma: melanin, intraepidermal melanocytic proliferation, nevoid component, positive for S100, MelanA and HMB45, negative for keratin
  • Primary penile sarcoma: usually in penile shaft, no squamous differentiation, no penile intraepithelial neoplasia, negative for p63 and keratin 34bE12
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