Penis & scrotum
Squamous cell carcinoma and variants
HPV independent squamous cell carcinoma
Carcinoma cuniculatum
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: Carcinoma cuniculatum penis
Table of Contents
Definition / general | Terminology | Epidemiology | Sites | Etiology | Clinical features | Case reports | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Differential diagnosisCite this page: Chaux A, Cubilla AL. Carcinoma cuniculatum. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/penscrotumscccuniculatum.html. Accessed May 30th, 2023.
Definition / general
- Rare, low grade variant of verruciform penile carcinoma with deeply penetrating and burrowing pattern of growth
- More common in plantar surface of foot, first described in 1954 (Br J Surg 1954;42:245)
Terminology
- Cuniculatum: from "cuniculus," rabbit's burrow (hole)
Epidemiology
- Elderly men
- Mean age 77 years (range 73 - 83 years)
Sites
- Glans and coronal sulcus frequently involved
- Multiple anatomical compartments usually affected
Etiology
- No evidence of HPV infection
Clinical features
- Slow growing
- Tumors may begin as small warts and slowly progress to larger tumors
- No reported cases with regional nodal metastasis or cancer related death
Case reports
- Series of seven cases (Am J Surg Pathol 2007;31:71)
Gross description
- Verruciform pattern of growth
- Average size 6.3 cm (range 5 - 9 cm)
- Tumor invade deep erectile tissues with a burrowing pattern of growth on cut section
- Stroma tumor interface sharply delimited
- Presence of cyst-like and sinus structures
- Fistulae to preputial or shaft skin are common
Gross images
Images hosted on other servers:
Ulcerated verrucous carcinoma
Microscopic (histologic) description
- Low grade keratinizing neoplastic nests resembling verrucous carcinoma
- Hyperkeratosis, papillomatosis and marked acanthosis
- Bulbous front of invasion
- Cyst-like and sinus lumina filled with hyperkeratotic material
- No / rare vascular and perineural invasion; no fibrovascular cores; no koilocytes
Microscopic (histologic) images
Contributed by Alcides Chaux, M.D. and Antonio Cubilla, M.D.
Cyst-like sinuses and tracts
Progressive
squamous maturation
and extensive
acantholysis
Images hosted on other servers:
Foot:
Verrucous carcinoma
Burrowing invasion of the dermis
Differential diagnosis
- Mixed (hybrid) usual - verrucous carcinoma: verrucous carcinoma with foci of usual squamous cell carcinoma typically located at tumor front, absence of a burrowing pattern of growth
- Verrucous carcinoma: similar in the exophytic component, usually limited to lamina propria or superficial corpus spongiosum and absence of a burrowing pattern of growth
- Warty carcinoma: condylomatous papillae with prominent fibrovascular cores, conspicuous koilocytosis and jagged tumor front
