OBJECTIVETo enhance the knowledge and the effect of the diagnosis and treatment of primary epithelioid sarcoma of the penis.

METHODSOne rare case of primary epithelioid sarcoma of the penis was studied with regard to its primary clinical process and characteristics, differential diagnosis and method of treatment.

RESULTSAn operation was performed on the penis to treat the epithelioid sarcoma. The diagnosis was confirmed by immunohistological and pathological techniques. There was no evidence of relapse during the three-year follow-up after operation.

CONCLUSIONThe possibility of primary epithelioid sarcoma of the penis should be considered if a mass or induration of the proximal penis and the symptoms of urethremphraxis are found. Total phallectomy could be chosen as an appropriate method of treatment. Unless adenopathy is palpable, node dissections are not recommended.

Adult ; Diagnosis, Differential ; Humans ; Male ; Penile Neoplasms ; diagnosis ; pathology ; surgery ; Sarcoma ; diagnosis ; pathology ; surgery

OBJECTIVETo investigate the clinical pathological characteristics, diagnosis and differential diagnosis of Paget's disease of the scrotum and penis.

METHODSThirteen cases of Paget's disease of the scrotum and penis were analyzed by light microscopy, alcian-blue (AB)/periodic-acid-Schiff (PAS) and immunohistochemical staining.

RESULTSPaget's disease of the scrotum and penis mainly affected old individuals aged 55-84 (mean 71) years. Macroscopically, typical presentations of Paget's disease of the scrotum and penis were eczematoid lesions. Microscopically, Paget cells were distributed singly or in groups (as strands, nests or glandular patterns) within the epidermis. Paget cells were typically stained for AB/PAS, positive for CK7, CEA and EMA, and negative for CK5/6, S-100 and P63. The positive rates of GCDFP-15 and CK20 expressions were 76.92% (10/13)and 53.85% (7/13) respectively.

CONCLUSIONPaget's disease of the scrotum and penis is a low-malignancy cutaneous tumor with typical clinical and pathological features. Pathologic diagnosis is based on immunohistochemical findings.

Aged ; Aged, 80 and over ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Paget Disease, Extramammary ; pathology ; Penile Neoplasms ; pathology ; Penis ; pathology ; Scrotum ; pathology

AIMTo study the clinical features of male genital schwannoma.

METHODSFive male patients with genital schwannoma admitted from 1991 to 2000 were reviewed. The lesions were located in the prostate, spermatic cord, testis or penis. Tumors were simply resected in 3 patients and radically eradicated in 2.

RESULTSThe average age of the cohort was 37 years. The most common sign at presentation was a palpable genital mass accidentally discovered by the patient or detected by the physician during a physical check. Diagnosis was made through postoperative pathological examination. Follow-up ranged from 2 years to 6 years (mean 4.5 years). Four cases were cured by simple excision and 1 patient with malignant testis schwannoma died of recurrence 1 year after surgery.

CONCLUSIONOwing to the lack of characteristic clinical manifestation, the final diagnosis relies on postoperative pathological examination. S-100 and vimentin are useful markers for the diagnosis of these tumors.

Adult ; Aged ; Genital Neoplasms, Male ; diagnosis ; pathology ; Humans ; Male ; Middle Aged ; Neurilemmoma ; diagnosis ; pathology ; Penile Neoplasms ; diagnosis ; pathology ; Prostatic Neoplasms ; diagnosis ; pathology ; Testicular Neoplasms ; diagnosis ; pathology

Human papillomavirus (HPV) infection appears to play an important role in the development of penile cancer (PeCa), but their relationship remains unclear. Therefore, we performed a systematic review and meta-analysis to elucidate their relationship. We systematically searched Embase, PubMed, Cochrane Library, and Web of Science for case-control studies and cross-sectional studies using polymerase chain reaction (PCR) technology on formalin-fixed paraffin-embedded (FFPE) or paraffin-embedded (PE) PeCa tissues to detect HPV (published between January 1, 2007, and December 29, 2017; no language restrictions). Twenty-two studies were identified, and 1664 cases were available for analysis. The combined HPV infectious risk of PeCa is 51.0% (95% confidence interval [CI]: 43.0%-60.0%). The three most common subtypes of HPV were HPV16 (28.5%), HPV18 (2.3%), and HPV6 (2.3%). The virus was relevantly associated with basaloid (85.5%, 95% CI: 77.2%-93.8%) and warty (50.0%, 95% CI: 35.2%-64.8%) carcinomas. The invasiveness of PeCa was not associated with HPV (χ^[2] = 0.181, df = 1, P < 0.671). HPV infection in PeCa tended to be moderately differentiated (54.4%, 95% CI: 47.7%-61.1%). This study found that almost half of PeCa patients are associated with HPV. The most commonly associated genotype is HPV16, but several other genotypes were also detected. In addition to types 6 and 11, other single low-risk HPV infections have been found to contribute to PeCa to a lesser degree. HPV-positive tumors tend to exhibit warty and/or basaloid features, corresponding to a moderate histological grade. The role of HPV in PeCa should be revisited to provide evidence for the development of PeCa in the presence of HPV infection.
Humans ; Male ; Papillomaviridae ; Papillomavirus Infections/pathology* ; Penile Neoplasms/virology* ; Risk Factors

Adult ; Fatal Outcome ; Humans ; Male ; Penile Neoplasms ; pathology ; physiopathology ; secondary ; Priapism ; etiology ; pathology ; Radiography ; Testicular Neoplasms ; complications ; diagnostic imaging ; physiopathology

OBJECTIVETo further understand the clinicopathological, ultrastructural and molecular features of penile pseudoangiosarcomatous squamous cell carcinoma (PASCC), and improve its diagnosis and treatment.

METHODSA 47-year-old male patient with penile PASCC was reported and the relevant literature reviewed. The main clinical manifestations of the patient were a typical surface ulceration with hemorrhage and purulent secretion with a foul smell, a papillary mass about 5.0 cm x 5.0 cm x 4.0 cm for 1 year on the foreskin of the penis, and 3 enlarged bilateral inguinal lymph nodes. CT scanning showed no enlarged lymph nodes in the abdomen and pelvis, and X-ray examination revealed no abnormality in the chest.

RESULTSThe diagnosis was established by biopsy. Partial penectomy and bilateral inguinal lymphadenectomy (T2N2M0) were performed, followed by adjuvant pelvic radiotherapy. Two months later, total penectomy was necessitated by penile flap necrosis and local recurrence. Eleven months after the first surgery, the patient died of extensive metastasis to the pelvis and lungs. Under the light microsope, the tumor was mainly composed of vessel-like lacunar reticularis spindle cells and a few local squamous cancer cells. Careful examination revealed some focal areas with evident transition from squamous nests to the more acantholytic areas extending towards the pseudoangiosarcomatous spaces. Pathogenetically, it appeared to be the variant of acantholytic squamous cell carcinoma. Immunohistochemically, most tumor cells were strongly positive for keratin (AE1/AE3) and focally positive for EMA, with the typical squamous cells focally positive for 34betaE12 and vimentin. The vessels that proliferated in the tumor were decorated by CD31, CD34 and factor VIII-related antigens, but the tumor cells were negative for HMB45, SMA, Desmin and CEA. HPV DNA (HPVpan, HPV6B/11, HPV16/18, HPV31/33) was not detected by in situ hybridization in the primary and metastatic tumors.

CONCLUSIONPASCC is a specific and extremely rare subtype of penile SCC with dramatic similarity to angiosarcoma under the microscope, with poor prognosis. Its diagnosis depends on histopathological, immunohistochemical and ultrastructural studies. Such a presentation underscores the importance of timely consultation, early diagnosis and prompt treatment.

Carcinoma, Squamous Cell ; pathology ; virology ; Humans ; Male ; Middle Aged ; Papillomaviridae ; isolation & purification ; Penile Neoplasms ; pathology ; virology ; Penis ; pathology ; virology

Adult ; Carcinoma, Squamous Cell ; etiology ; pathology ; Humans ; Lichen Sclerosus et Atrophicus ; complications ; pathology ; Male ; Penile Neoplasms ; etiology ; pathology ; Time Factors

Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Carcinoma, Verrucous ; pathology ; Condylomata Acuminata ; pathology ; virology ; Diagnosis, Differential ; Human papillomavirus 11 ; isolation & purification ; Humans ; Hyperplasia ; Male ; Middle Aged ; Penile Diseases ; metabolism ; pathology ; virology ; Penile Neoplasms ; pathology ; Penis ; pathology ; Xanthomatosis ; metabolism ; pathology ; virology

Gadolinium ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Penile Neoplasms ; diagnosis ; diagnostic imaging ; drug therapy ; pathology ; Penis ; pathology ; Radionuclide Imaging

OBJECTIVETo explore the diagnosis and treatment of penile verrucous carcinoma.

METHODSThe clinical and pathological data of 4 patients with penile verrucous carcinoma were analyzed.

RESULTSThe patients ranged in age from 42 to 76 years (average 52). All the tumors showed exophytic papillary lesions, the biggest being 2.1 to 5.8 cm in diameter. The lesions were confined to the glans penis in two cases and invaded the shafts in the other 2 (1 accompanied by syphilis). One patient, whose tumor was small (1.4 cm in diameter) and confined to the glans penis, underwent glandectomy. One with a larger tumor confined to the glans penis and the other 2 with the shafts involved underwent partial penectomy, including the one accompanied by syphilis, who underwent the operation after treated by Benzathine benzylpenicillin. Histopathological examination of the specimens showed that the tumor cells were mostly well-differentiated and the surgical margins were tumor free in all the 4 cases. HE stain was performed in all the specimens. Microscopic examination revealed papillomatosis and hyperkeratosis of the epithelium, with bulbous projections into the lamina propria consisting of well-differentiated squamous epithelial cells. Marked invasion of the stroma by lymphocytes was noted. Follow-up ranged from 3 to 7 years (average 4.6), revealing no recurrence. The result of the rapid plasma regain (RPR) test was negative but that of the Treponema pallidum passive-particle-agglutination (TPPA) test remained positive in the blood of the patient accompanied by syphilis after treatment.

CONCLUSIONVerrucous carcinoma of the penis is characterized by low malignant potential and locally aggressive nature. It seldom develops metastasis to regional lymphonodes or distant areas. Glandectomy or partial penectomy can be chosen for its treatment, with favorable prognosis.

Aged ; Carcinoma, Verrucous ; diagnosis ; pathology ; surgery ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Penile Neoplasms ; diagnosis ; pathology ; surgery