Diagnosis and Pathology of Penile Cancer

Abstract

Malignant tumors of the penis affect mainly the distal portion of the penis with the majority being squamous cell carcinomas (SCC). Several SCC histologic subtypes are recognized, each with distinctive clinicopathological and outcome features. These subtypes include usual SCC, warty, basaloid, warty-basaloid, papillary, verrucous, pseudoglandular, pseudohyperplastic, and sarcomatoid carcinomas. These malignant tumors begin as penile intraepithelial neoplasias (PeIN) and progress to infiltrate the erectile tissues and vascular spaces. Other epithelial tumors affecting the penis include extramammary Paget's disease, malignant melanoma, and clear cell carcinoma. Non-epithelial tumors, such as malignant lymphomas and sarcomas, can also be seen on occasion. The penis can also be affected by secondary tumors, mainly originating within the genitourinary or gastrointestinal tract. Pathological prognostic factors include histological grade and subtype, anatomical level of infiltration, perineural/vascular invasion, amongst others. In this chapter we cover the main macroscopic and microscopic features of these malignant lesions providing a unified framework for histopathologic diagnosis.

An overview of the diagnoses and treatments for penile cancer

“…Penile cancer develops from premalignant cells known as penile intra-epithelial neoplasia (PeIN) (Figure 3c), which clinically presents as whitish irregular patches on the skin or sharply defined with a red smooth appearance (Chaux et al, 2016).…”

“…The majority of tumours (over 95%) are squamous cell carcinomas (SCC), of which there are several recognised subtypes: warty, papillary, basaloid, verrucous and sarcomatoid (Hakenberg et al, 2018). Other non-SCC include sarcomatoid tumours, malignant melanoma, extramammary pagets and malignant lymphomas (Chaux et al, 2016).…”