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Indian Journal of Sexually Transmitted... 2015Cutaneous horn refers to unusually cohesive keratinized material and not a true pathologic diagnosis. Though cutaneous horn has been described at various sites, horn... (Review)
Review
Cutaneous horn refers to unusually cohesive keratinized material and not a true pathologic diagnosis. Though cutaneous horn has been described at various sites, horn over the penis is very rare and represents the most unusual site. The role of chronic irritation, phimosis, surgical trauma and radiotherapy have been implicated in penile horn formation. Penile horns present as elongated, keratinous, white or yellowish projections that range from a few millimeters to centimeters in size arising from the glans penis. Histopathology of the keratotic mass reveals nothing but keratin. The underlying mass may vary from verruca vulgaris to squamous cell carcinoma. The treatment is based on the pathology.
PubMed: 26392650
DOI: 10.4103/0253-7184.156692 -
International Braz J Urol : Official... 2021Squamous cell carcinoma (SCC) of the penis is a rare disease in developed countries but is associated with significant morbidity and mortality. A crucial prognostic... (Review)
Review
PURPOSE
Squamous cell carcinoma (SCC) of the penis is a rare disease in developed countries but is associated with significant morbidity and mortality. A crucial prognostic factor is the presence of inguinal lymph node metastases (ILNM) at the time of diagnosis. At least 25% of cases have micrometastases at the time of diagnosis. Therefore, we performed a literature review of studies evaluating factors, both clinical and pathological, predictive of lymph node metastases in penile SCC.
MATERIALS AND METHODS
Studies were identified using PubMed and search terms included the following: penile cancer, penile tumor, penile neoplasm, penile squamous cell carcinoma, inguinal lymph node metastasis, lymph node metastases, nodal metastasis, inguinal node metastasis, inguinal lymph node involvement, predictors, and predictive factor. The number of patients and predictive factors were identified for each study based on OR, HR, or RR in multivariate analyses, as well as their respective significance values. These were compiled to generate a single body of evidence supportive of factors predictive of ILNM in penile SCC.
RESULTS
We identified 31 studies, both original articles and meta-analyses, which identified factors predictive of metastases in penile SCC. The following clinical factors were predictive of ILNM in penile SCC: lymphovascular invasion (LVI), increased grade, increased stage (both clinical and pathological), infiltrative and reticular invasion, increased depth of invasion, perineural invasion, and younger patient age at diagnosis. Biochemically, overexpression of p53, SOD2, Ki-67, and ID1 were associated with spread of SCC to inguinal lymph nodes. Diffuse PD-L1 expression, increased SCC-Ag expression, increased NLR, and CRP >20 were also associated with increased ILNM.
CONCLUSIONS
A multitude of factors are associated with metastasis of SCC of the penis to inguinal lymph nodes, which is associated with poor clinical outcomes. The above factors, most strongly LVI, grade, and node positivity, may be considered when constructing a nomogram to risk-stratify patients and determine eligibility for prophylactic inguinal lymphadenectomy.
Topics: Humans; Lymph Node Excision; Lymph Nodes; Lymphatic Metastasis; Male; Penile Neoplasms; Prognosis
PubMed: 33650835
DOI: 10.1590/S1677-5538.IBJU.2020.0959 -
Advances in Anatomic Pathology May 2023Genitourinary malignancies include a broad spectrum of distinct tumor entities occurring in the kidney, the urinary tract, the prostate, the adrenal glands, the penis,... (Review)
Review
Genitourinary malignancies include a broad spectrum of distinct tumor entities occurring in the kidney, the urinary tract, the prostate, the adrenal glands, the penis, and testicles. Each tumor entity presents with unique biological characteristics, especially in terms of immunobiology. The immune landscape of genitourinary malignancies differs between immunoreactive tumors like urothelial carcinoma or carcinomas of the kidney, for which several immunotherapeutic treatment options have been approved in the past years. In contrast, prostate cancer presents with low immunogenicity and previous trials exploring immune checkpoint inhibitors and other immunotherapeutic agents did not proof substantial survival benefits. In this review, we are presenting a streamlined overview on the role of surgical pathologists within the contemporary practice of immune oncology. It includes current indications for pathologic programmed death-ligand 1 (PD-L1) assessment and important pathologic considerations on PD-L1 testing harmonization including interassay and algorithm variabilities. In addition, we will discuss emerging biomarkers beyond PD-L1 and their potential to predict immunotherapy responses including tumor mutational burden, microsatellite instability, gene expression signatures, and histologic factors.
Topics: Male; Humans; Urinary Bladder Neoplasms; B7-H1 Antigen; Carcinoma, Transitional Cell; Pathologists; Programmed Cell Death 1 Receptor; Biomarkers, Tumor; Immunotherapy
PubMed: 36730368
DOI: 10.1097/PAP.0000000000000383 -
Virchows Archiv : An International... Dec 2023The classification of the epithelial tumors of the male and female urethra includes benign and malignant neoplasms. Primary urethral carcinomas and adenocarcinomas of... (Review)
Review
The classification of the epithelial tumors of the male and female urethra includes benign and malignant neoplasms. Primary urethral carcinomas and adenocarcinomas of the accessory glands are the most relevant tumors, both from the morphologic and clinical point of view. An accurate diagnosis, grading and staging are essential for determining adequate treatment strategies and outcome. Information on anatomy and histology of the urethra is of fundamental importance in understanding the morphology of the tumors, including the clinical importance of their location and origin.
Topics: Humans; Male; Female; Urethra; Adenocarcinoma; Biomarkers, Tumor; Urethral Neoplasms
PubMed: 37233807
DOI: 10.1007/s00428-023-03565-y -
Andrology Nov 2020Penile cancer represents a rare pathology whose natural history of treatment is poorly understood.
BACKGROUND
Penile cancer represents a rare pathology whose natural history of treatment is poorly understood.
OBJECTIVE
To illustrate the dynamic survival profiles in surgically treated patients with squamous cell carcinoma of the penis (SCCP) using the conditional survival (CS) estimates.
MATERIALS AND METHODS
Patients with non-metastatic SCCP were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Conditional 3-yr overall survival (OS) rate and 3-yr cancer-specific survival (CSS) rate represented the primary outcomes of interest and were calculated using the Kaplan-Meier method. The multivariable Cox regression model was employed to calculate proportional hazard ratios for the prediction of mortality.
RESULTS
A total of 1887 SCCP patients who had undergone surgeries were identified. Given a 1-, 2-, 3-, 4-, and 5-yr survivorship, the 3-yr OS rates were, respectively, improved by + 9.8 (72.6%), +18.2 (78.1%), +23.4 (81.6%), +27.8 (84.5%), and + 26.6% (83.7%) from those calculated at baseline (time zero). As compared with the baseline calculations, patients who had survived 1, 2, 3, 4, or 5 yr after surgery could, respectively, harvest a + 7.8 (84.7%), +14.8 (90.2%), +19.5 (93.9%), +22.1 (96.0%), and + 22.4% (96.2%) improvement in 3-yr CSS. Patients with the most aggressive disease at baseline ultimately benefited the most from event-free survivorship. Multivariable Cox regression analyses showed that the impact of adverse pathological parameters (G2-3, ≥ pT2, pN+) on OS and CSS mostly showed a decreasing trend over time and some could disappear after a minimum of 1-yr survivorship.
DISCUSSION AND CONCLUSION
The survival probability of SCCP patients increases with post-operative survival. Patients with aggressive disease at baseline ultimately benefit the most from event-free survivorship and may expect a better prognosis once they survive the critical few years after surgery. The recorded observations have crucial implications regarding patient counseling and follow-up.
Topics: Aged; Carcinoma, Squamous Cell; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Neoplasm Staging; Penile Neoplasms; Prognosis; SEER Program
PubMed: 32619060
DOI: 10.1111/andr.12856 -
European Urology Focus Sep 2019Primary urethral cancer (PUC) is a rare cancer entity. Owing to the low incidence of this malignancy, the main body of literature consists mainly of case reports, making...
CONTEXT
Primary urethral cancer (PUC) is a rare cancer entity. Owing to the low incidence of this malignancy, the main body of literature consists mainly of case reports, making evidence-based management recommendations difficult.
OBJECTIVE
To review reported disease management strategies of PUC and their impact on oncological outcomes.
EVIDENCE ACQUISITION
A systematic research was performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement using Medline, Scopus, and Web of Science, to find studies of the past 10yr including ≥20 patients, and investigating treatment strategies and their impact on outcomes of the three most frequent histologies: urothelial carcinoma, adenocarcinoma, and squamous cell carcinoma.
EVIDENCE SYNTHESIS
In localized PUC, penis-sparing surgery can be performed in males, while in females, complete urethrectomy with surrounding tissue is advised to minimize recurrence due to positive margins. Radiotherapy (RT) has worse survival and recurrence rates, as well as more adverse effects, than surgery, limiting its use in genital-preserving therapy. Locally advanced PUC should be treated with multimodal therapy, as monotherapies result in inferior recurrence and survival rates. Extent of surgery is still undecided, favoring radical cyst(oprostat)ectomy with total urethrectomy (RCU). Lymph node involvement is a predictor of survival, highlighting the role of lymph node dissection for disease control and staging. RT can improve survival in combination with surgery and/or chemotherapy (CHT). Neoadjuvant platinum-based CHT can improve overall and recurrence-free survival. At recurrence, salvage therapy with surgery and/or CHT can improve survival. Superficial urothelial carcinoma of the prostatic urethra can be treated with transurethral resection. Stromal invasion often features concomitant bladder cancer with a poor prognosis and requires RCU with or without systemic preoperative CHT.
CONCLUSIONS
PUC is a rare malignancy with an often poor natural course, requiring a stage- and gender-specific risk-based treatment strategy. The role of systematic perioperative CHT and the extent of surgery are becoming more important.
PATIENT SUMMARY
In this review, we looked at the treatment options for primary urethral cancer. We found that while an organ-confined disease can be managed with local resection, growth beyond the organ border makes a combination of different treatment modalities, such as surgery and systematic chemotherapy, necessary to improve outcomes.
Topics: Adenocarcinoma; Carcinoma, Squamous Cell; Carcinoma, Transitional Cell; Decision Trees; Female; Humans; Male; Urethral Neoplasms
PubMed: 31307949
DOI: 10.1016/j.euf.2019.07.001 -
Indian Journal of Surgical Oncology Mar 2017Sarcomatoid carcinomas are biphasic tumours, which occur at any site in the human body. It rarely affects the penis, with only 38 cases being reported in literature. It...
Sarcomatoid carcinomas are biphasic tumours, which occur at any site in the human body. It rarely affects the penis, with only 38 cases being reported in literature. It may be considered as a variant of squamous cell carcinoma or a dedifferentiated tumour. We report a 60-year old gentleman who presented with a swelling in the glans penis. He underwent a partial penectomy. Histopathology revealed sarcomatoid carcinoma of the penis, which was confirmed by immunohistochemistry. The rarity of this clinical entity makes its diagnosis difficult.
PubMed: 28127189
DOI: 10.1007/s13193-016-0531-3 -
Asian Journal of Surgery Jun 2024
PubMed: 38839497
DOI: 10.1016/j.asjsur.2024.05.189 -
Case Reports in Pathology 2017Penile carcinoma frequency varies widely in different parts of the world and comprises 1-10% of all the malignancies in males. Majority of the cases of penile carcinoma...
Penile carcinoma frequency varies widely in different parts of the world and comprises 1-10% of all the malignancies in males. Majority of the cases of penile carcinoma are squamous cell carcinoma of penis comprising 60% to 70% of all cases. Warty carcinoma of penis is an unusual neoplasm and a variant of penile squamous cell carcinoma comprising 5%-10% of all the variants. The other histological variants include basaloid, verrucous, papillary, sarcomatous, mixed, and adenosquamous carcinoma. The various histological entities with an exophytic papillary lesions including warty carcinoma are together referred to as the "verruciform" group of neoplasms. The warty carcinoma has to be differentiated from these lesions and is typically distinguished by histological features of hyperkeratosis, arborescent papillomatosis, acanthosis, and prominent koilocytosis with nuclear pleomorphism. We present a case of 65-year-old male with growth measuring 6 × 4 cm in the penis who underwent total penectomy and was diagnosed as warty carcinoma penis.
PubMed: 28154768
DOI: 10.1155/2017/2937592 -
PloS One 2022p16 (CDKN2A) is a member of the INK4 class of cell cycle inhibitors, which is often dysregulated in cancer. However, the prevalence of p16 expression in different cancer...
p16 (CDKN2A) is a member of the INK4 class of cell cycle inhibitors, which is often dysregulated in cancer. However, the prevalence of p16 expression in different cancer types is controversial. 15,783 samples from 124 different tumor types and 76 different normal tissue types were analyzed by immunohistochemistry in a tissue microarray format. p16 was detectable in 5,292 (45.0%) of 11,759 interpretable tumors. Except from adenohypophysis in islets of Langerhans, p16 staining was largely absent in normal tissues. In cancer, highest positivity rates were observed in uterine cervix squamous cell carcinomas (94.4%), non-invasive papillary urothelial carcinoma, pTaG2 (100%), Merkel cell carcinoma (97.7%), and small cell carcinomas of various sites of origin (54.5%-100%). All 124 tumor categories showed at least occasional p16 immunostaining. Comparison with clinico-pathological data in 128 vulvar, 149 endometrial, 295 serous ovarian, 396 pancreatic, 1365 colorectal, 284 gastric, and 1245 urinary bladder cancers, 910 breast carcinomas, 620 clear cell renal cell carcinomas, and 414 testicular germ cell tumors revealed only few statistically significant associations. Comparison of human papilloma virus (HPV) status and p16 in 497 squamous cell carcinomas of different organs revealed HPV in 80.4% of p16 positive and in 20.6% of p16 negative cancers (p<0.0001). It is concluded, that a positive and especially strong p16 immunostaining is a feature for malignancy which may be diagnostically useful in lipomatous, urothelial and possibly other tumors. The imperfect association between p16 immunostaining and HPV infection with high variability between different sites of origin challenges the use of p16 immunohistochemistry as a surrogate for HPV positivity, except in tumors of cervix uteri and the penis.
Topics: Biomarkers, Tumor; Carcinoma, Squamous Cell; Carcinoma, Transitional Cell; Cyclin-Dependent Kinase Inhibitor p16; DNA, Viral; Female; Humans; Papillomaviridae; Papillomavirus Infections; Prevalence; Staining and Labeling; Urinary Bladder Neoplasms
PubMed: 35862385
DOI: 10.1371/journal.pone.0262877