Abstract

Penile squamous cell carcinoma (SCC) is a rare malignancy that primarily affects elderly men.  The HPV status of the tumor, determined by ISH or p16 as a surrogate marker, is important to consider in the diagnosis and management of penile SCC.

This retrospective analysis examined 9 cases and 7 patients diagnosed with either penile SCC or penile squamous carcinoma in situ (PeIN) from a single institution between 2015 and 2023. The average age was 64.5 years; five (71%) were Caucasian, one (14%) black, and two (29%) other; and, five (71%) were smokers.  Six biopsies and three resections were performed, with locations of shaft, glans and periurethra.  All three biopsies on which p16 was performed were positive (100%), and two of the resections were p16 positive (67%).  

The tumors presented with various histological features.  Among the biopsies, three were PeIN, two were poorly differentiated carcinoma, and one was squamous carcinoma with basaloid features.  Of the resections, two were poorly differentiated, and one was well-differentiated warty carcinoma. The average tumor size from resections was 3.93 cm.  All specimens from the resections had negative margins, with two being pT3pN0 and one being pT2pN1.  Two (29%) of the biopsies and all three resections (100%) had lymphovascular invasion (LVI). None of the biopsies and two resection specimens (67%) had perineural invasion.  

These findings highlight the histopathologic and clinical findings of penile SCC (in-situ or invasive). Further research is needed to expand our understanding of the pathogenesis and management of this disease.