Autopsy Findings in 14 Patients With Penile Squamous Cell Carcinoma

Abstract

The aim of this study was to describe pathologic features found at autopsy of 14 patients with penile cancer. Nine patients died from disseminated disease; 5 of them presented local/regional recurrences. Five patients died from other causes, 2 of them postoperatively. Local recurrence sites were corpus cavernosum, Buck's fascia and urethra, regional skin, and prostate. Metastatic sites were lymph nodes (9 cases), liver (7 cases), lungs (6 cases), heart (5 cases), adrenals, bone and skin (3 cases each), thyroid and brain (2 cases each), and pancreas, spleen, and pleura (1 case each). Patients with heart metastasis had arrhythmias. Patients who died and who did not die from penile cancer had different profiles: low-grade superficial tumors with usual and warty subtypes versus high-grade deeply invasive basaloid or hybrid verrucous/sarcomatoid carcinomas. A natural history model for penile cancer routes of spread is proposed: local intrapeneal, regional and systemic nodes, regional skin, liver, lungs, heart, and other multiple sites.

The Basaloid Cell is the Best Tissue Marker for Human Papillomavirus in Invasive Penile Squamous Cell Carcinoma: A Study of 202 Cases From Paraguay

“…Histologic subtypes such as basaloid, sarcomatoid, and high-grade SCC are associated per se with an adverse outcome, whereas in others (verruciform tumors, including lowgrade warty variants, and low grade usual SCC) the mortality rate is significantly lower. 11,20 To consider only the HPV status regardless of the histologic subtype of the tumor could cause considerable misleading. For a proper evaluation of the HPV infection impact in the patients' outcome, comparisons of HPV positive and negative tumors of the same histologic subtype should be carried out.…”

“…Positive samples were subsequently genotyped LI-PA 25 (version 1, produced at Labo Biomedical Products, Rijswijk, the Netherlands). All SPF 10 LI-PA 25 PCR detection was performed at Institut d'Oncologia (ICO, Barcelona) and at the facilities of DDL Diagnostic Laboratories (DDL, Voorburg, the Netherlands) using the previously described protocol by Kleter et al 23,24 The HPV LiPA 25 version 1 allows specific detection of 25 HPV types: HPV 6,11,16,18,31,33,34,35,39,40,42,43,44,45,51,52,53,54,56,58,59,66,68 or 73, 70, and 74. HPV genotypes were classified in low and high risk after the epidemiologic criteria established by Mun˜oz et al 9 : genotypes 16,18,31,33,35,39,45,51,52,56,58,59,68,82,26,53,66, and 73 are associated with a high risk and genotypes 6,11,40,42,43,44,…”

Advances in the pathology of penile carcinomas

“…Death from cancer usually occurs within 2 to 3 years of initial diagnosis [16]. In an autopsy study, metastatic sites included the lymph nodes (pelvic, retroperitoneal, and mediastinal), liver, lungs, bone, and myocardium [53].…”

Intracardiac metastasis of squamous cell carcinoma of the penis

“…In a series involving 14 autopsies of patients with penile squamous cell carcinoma, the distant metastatic sites were concentrated in lymph nodes, liver, lungs, and the heart. The latter was characterized by myocardial involvement and clinically by arrhythmias 11. In contrast, Neuzillet et al7 reported the metastatic sites of squamous carcinoma of the penis in a decreasing frequency as follows: lymph nodes, lungs, liver, bones, and exceptionally the brain, skin, kidneys, adrenals, and heart.…”

“…Penile squamous cell carcinoma usually spreads as follows: sentinel inguinal node(s), superficial inguinal lymph nodes, deep inguinal lymph nodes, pelvic lymph nodes, periaortic lymph nodes, mediastinal lymph nodes, regional dissemination to skin of groin, scrotum, perineum, direct invasion of prostate, and systemic dissemination to multiple sites like liver, lungs, and heart 5 , 11. In a series involving 14 autopsies of patients with penile squamous cell carcinoma, the distant metastatic sites were concentrated in lymph nodes, liver, lungs, and the heart.…”