We evaluated clinicopathological features and outcomes in patients with penile squamous cell carcinoma.
We studied 333 patients with homogeneous surgical treatment, including circumcision in 4, local excision in 2, partial penectomy in 194 and total penectomy in 133. Of the patients 153 also underwent bilateral groin dissection. Followup was 8 to 453 months (average 100).
The usual type of squamous cell carcinoma was noted in 65% of cases. Higher histological grade, deeper anatomical infiltration, and vascular and perineural invasion were common findings in sarcomatoid, basaloid and adenosquamous carcinoma cases, correlating with a higher rate of nodal metastasis and mortality. These features were unusual in verrucous, papillary and warty carcinoma cases. Recurrence in 22% of cases was common for the sarcomatoid, basaloid and adenosquamous types but was not noted for verrucous carcinoma. Locoregional relapse was more common in cases of usual, mixed, papillary and warty carcinoma, and systemic relapse was typical in sarcomatoid and basaloid carcinoma cases. The overall metastasis rate was 24% and the 10-year survival rate was 82%. The highest mortality rate was observed within the first 3 years of followup. High grade tumors were more common in penectomy cases and carcinoma exclusive of the foreskin had a better prognosis. The nodal metastasis risk groups were low--verrucous, papillary and warty, intermediate--usual and mixed, and high risk--sarcomatoid, basaloid and adenosquamous. Mortality risk groups were low--mixed, papillary and warty, intermediate--usual and basaloid, and high risk--sarcomatoid.
These data should help clinicians to design therapeutic strategies and followup protocols.
"In addition, to consider only the T stage of the penile tumor to define the type and extension of primary treatment could be misleading. Some tumor variants, such as basaloid, sarcomatoid and high-grade usual carcinomas are intrinsically aggressive, regardless of the anatomical level of infiltration (Chaux et al. 2009; Velazquez et al. 2005; Guimarães et al. 2009). Other tumor variants, such as carcinoma cuniculatum, could invade deep erectile "
[Show abstract][Hide abstract] ABSTRACT: To report the clinicopathologic and outcome features of superficial high-grade and deep low-grade penile squamous cell carcinomas.
From a retrospectively-collected series of patients with penile cancer we identified 41 cases corresponding to 12 superficial high-grade tumors and 29 deep low-grade tumors. As outcomes we evaluated inguinal lymph node status, presence of tumor relapse, final nodal status, and cancer-specific death. Follow-up ranged from 0.8 to 386.7 months (mean 152.5 months, median 157.3 months).
Clinicopathologic features were similar between superficial high-grade and deep low-grade tumors, except for a tendency (Fisher's exact [Formula: see text]) of the former to include tumors with a verruciform pattern of growth. A significantly higher proportion of inguinal lymph node metastasis was found in superficial high-grade tumors compared to deep low-grade tumors [4/5 (80%) vs. 1/5 (20%) respectively, Fisher's exact [Formula: see text]]. No significant differences were found regarding tumor relapse (Fisher's exact [Formula: see text]), final nodal status (Mantel-Cox's [Formula: see text]), or cancer-related death (Mantel-Cox's [Formula: see text]).
Patients with superficial high-grade tumors had a significantly higher proportion of inguinal lymph node metastasis compared to patients with deep low-grade tumors. On this regard, prophylactic inguinal lymphadenectomy might be indicated in cases of superficial tumors with high-grade histology while in deeply invasive low-grade penile carcinomas a more conservative approach may be considered.
[Show abstract][Hide abstract] ABSTRACT: Granuloma inguinale (GI) is an acquired chronic, slowly progressive, mildly contagious disease of venereal origin, characterized by granulomatous ulceration of the genitalia and neighboring sites, with little or no tendency to spontaneous healing caused by Klebsiella (Calymmatobacterium) granulomatis. A 55-year-old male presented with fissured, foul smelling, fungating growth over prepuce with phimosis mimicking squamous cell carcinoma (SCC) without lymphadenopathy. It started with painless papulonodular showed pseudoepitheliomatous hyperplasia, infiltration in dermis, acanthosis and vacuolated macrophages suggestive of GI and not showing any histopathological features of SCC. Patient was successfully treated by giving cotrimoxazole twice a day for 21 days. Here, we presented a case of GI mimicking SCC of penis, which was diagnosed on basis of histopathology and treated with excision followed by medical therapy with cotrimoxazole.
Indian Journal of Sexually Transmitted Diseases and AIDS 04/2014; 35(1):56-8. DOI:10.4103/0253-7184.132433
"Guimarães et al., have documented a 10% recurrence rate for WC when compared to 28% for SC-NOS. The follow-up in our series was not complete. "
[Show abstract][Hide abstract] ABSTRACT: There are few studies on the pathology of warty carcinoma (WC) of the penis and these have been from South America. Penile cancers are not uncommon in India. We reviewed the frequency of subtypes of penile squamous carcinoma (SC) and the pathological features and outcome of WC when compared to squamous carcinoma-not otherwise specified (SC-NOS). We also compared the clinicopathological features of WC in our series with those published earlier.
We studied 103 cases of penile cancers over 6 years. Cases were classified into different subtypes according to established histologic criteria. Clinicopathologic features were studied in detail and compared among the different subtypes, especially between WC and SC-NOS. The patients were followed-up and disease free survival in months was noted.
SC-NOS constituted 75.7% of all penile cancer cases in our series. The frequency of other subtypes was WC: 9.7%, verrucous: 3.9%, basaloid type and papillary type: 0.97% each, and mixed types 8.7%. The average tumor size and depth of invasion did not differ significantly between the two subtypes. Frequency of lymphovascular emboli and percentage of lymph node metastasis in WC (30 and 10%) were lesser than in SC-NOS (49.37 and 26.58%), respectively. There were no recurrences after partial penectomy in the WC subtype. In the SC-NOS type, three cases had recurrence after partial/total penectomy.
Warty carcinoma constitutes nearly 10% of all penile squamous cell cancers. These patients seem to have a less aggressive behavior than SC-NOS.
Indian Journal of Urology 10/2013; 29(4):282-7. DOI:10.4103/0970-1591.120106
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