Department of Pathology

IRCCS National Cancer Institute Milan

ICCR
 
CARCINOMA OF THE PENIS
MAURIZIO COLECCHIA
MILAN
Operative procedure Department of Pathology
IRCCS National Cancer Institute Milan

Penectomy, partial
Penectomy, radical
Glans resurfacing
Glansectomy
Circumcision
Incisional/punch biopsy
Excisional biopsy
Lymphadenectomy(Sentinel -Left, specify number of site/s
Right, specify number of site/s)
Inguinal (Left, specify site/sRight, specify site/s<9
Pelvic (Left, specify site/sRight, specify site/s<9
Other, specify
Other, specify laterality and site/s
Excisional biopsy Department of Pathology
IRCCS National Cancer Institute Milan

laser biopsy
 Department of Pathology
IRCCS National Cancer Institute Milan
 Department of Pathology
IRCCS National Cancer Institute Milan
Macroscopic tumour site Department of Pathology
IRCCS National Cancer Institute Milan

REQUIRED: Yes

• Glans penis
• Sulcus
• Foreskin
• Distal penile urethra
• No macroscopically visible tumour
• Indeterminate
Macroscopic tumour dimensions Department of Pathology
IRCCS National Cancer Institute Milan

REQUIRED: Yes

• Maximum tumour width: ___ mm

• Maximum tumour thickness: ___ mm
• Cannot be assessed Not applicable
Reason/Evidentiary Support:
Measurement of the depth of invasion, measured in
millimetres from the basement membrane of the
adjacent epithelium to the deepest point of invasion,
or the maximum thickness or size of the tumour may
also give prognostic information as seen in squamous
tumours of other sites such as skin. Minimal risk for
metastasis is reported for tumors measuring less than
5 mm in thickness
Histological tumour type
Department of Pathology
IRCCS National Cancer Institute Milan

REQUIRED: Yes

• Squamous cell carcinoma of usual subtype (NOS)

• Basaloid squamous cell carcinoma
• Warty (condylomatous) squamous cell carcinoma
• Verrucous squamous cell carcinoma
• Papillary squamous cell carcinoma
• Mixed squamous cell carcinomas (specify subtypes)
• Other (see extended list in commentary from WHO
classification 2016)
Histological grade
Department of Pathology
IRCCS National Cancer Institute Milan

REQUIRED: Yes
• Not applicable
• G1: Well differentiated
• G2: Moderately differentiated
• G3: Poorly differentiated
• Sarcomatoid areas present separate category
Reason/Evidentiary Support:
Accurate staging and grading of tumours are used to determine subsequent clinical
management and follow-up. …There is no consensus concerning grading, and the ent
World Health Organisation (WHO) classification (2004) does not make a specific
recommendation. The most recent CAP guidelines offer some outline global guidance
which is applicable to usual type squamous carcinomas.The “classical” method defines
well-, moderately-well and poorly differentiated carcinomas on the basis of the degree
of cytological atypia, keratinisation, intercellular bridges and mitotic activity (see
table 1). Sarcomatoid change is a separate category, which is often combined with
other tumour types and which conveys a very poor prognosis.
Grading of penile squamous cell carcinoma Department of Pathology
IRCCS National Cancer Institute Milan
Penile carcinoma -Grade
Department of Pathology
IRCCS National Cancer Institute Milan

M Colecchia ed. “Pathology of Testicular and

”
Penile Neoplasms” Springer , Basel 2016
Microscopic tumour dimensions Department of Pathology
IRCCS National Cancer Institute Milan

• REQUIRED: Yes
• Maximum tumour width: ___ mm
• Maximum tumour thickness: ___ mm
• Cannot be assessed
• Not applicable
Extent of invasion
Department of Pathology
IRCCS National Cancer Institute Milan

REQUIRED: Yes
• Primary tumours of the penis and foreskin
– Subepithelial/lamina propria invasion by tumour
– Invasion of corpus spongiosum of glans
– Invasion of corpus cavernosum
– Invasion of the penile urethra
– Invasion of adjacent structures, specify
• Primary tumours of the distal urethra
– Subepithelial/lamina propria invasion by tumour
– Invasion of corpus spongiosum
– Invasion of corpus cavernosum
– Invasion of adjacent structures (e.g. bulbar or prostatic urethra, prostate),
specify
Lymphovascular invasion Department of Pathology
IRCCS National Cancer Institute Milan

Perineural invasion
Margin status
• Not applicable
• Cannot be assessed
• Not involved
– Distance to invasive tumour
• _____mm OR
• > 5mm
• Involved by PeIN only
• Involved by invasive carcinoma
•  
 Department of Pathology
IRCCS National Cancer Institute Milan
Lymph node status Department of Pathology
IRCCS National Cancer Institute Milan

– Number of lymph nodes examined _____

• Not submitted
• Not involved
• Isolated tumour cells only
• Involved
• Number of positive lymph nodes ______
• Number cannot be determined
• Maximum dimension of largest deposit ___mm
• Extracapsular spread
• Present
• Not identified
 Department of Pathology
IRCCS National Cancer Institute Milan
 Department of Pathology
IRCCS National Cancer Institute Milan
Pathologic staging
Department of Pathology
IRCCS National Cancer Institute Milan

• Element name 1: TNM descriptors (AJCC 7th edition)

• REQUIRED: Yes, if applicable