Case of the Week

2019-33 / SEPTEMBER 30 (CONTRIBUTOR: SOUNAK GUPTA)

CASE HISTORY

An 82-year-old male with a prior history of rectal adenocarcinoma (treated surgically, followed by adjuvant chemo and radiation therapy) and upper tract urothelial disease (treated with a right sided nephroureterectomy) was recently diagnosed with penile cancer.

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Quiz

The partial penectomy specimen revealed poorly differentiated squamous cell carcinoma of the glans penis. How would you stage this specimen?

a. pT1a

b. pT1b

c. pT2

d. pT3

Tumors involving the glans penis commonly spread horizontally to involve the coronal sulcus and foreskin. In this case, vertical spread to the corpus spongiosum was noted. Vertical spread is commonly seen with basaloid and sarcomatoid squamous cell carcinoma, with involvement of the urethra. Other routes of spread include the penile fascia. Positive surgical margins are often due to involvement of the urethra or penile fascia.
pT1a disease is defined as subepithelial connective tissue invasion without lymphovascular/perineural invasion and is not high-grade (grade 3 or sarcomatoid). In contrast, pT1b disease is defined as subepithelial connective tissue invasion with lymphovascular invasion and/or perineural invasion or is high-grade. pT2 tumors invade the corpus spongiosum with or without urethral invasion. pT3 tumors invade the corpora cavernosum including tunica albuginea and pT4 tumors invade adjacent structures (i.e. scrotum, prostate, pubic bone).

About GUPS

The Genitourinary Pathology Society (GUPS) was formed with the vision of advancing the care of patients with urologic diseases through enhancements of best practices, research, and education in the subspecialty of Urological Pathology.

GUPS is an official Companion Society of the United States and Canadian Academy of Pathology (USCAP).

Contact

gupathologysociety@gmail.com

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