PATHOLOGICAL FEATURES OF EPIDERMOID CARCINOMA OF THE PENIS - A PROSPECTIVE-STUDY OF 66 CASES

We report a whole-organ-section pathologic study of 66 cases of epider moid carcinoma of the penis. Specimens were divided into three compart ments: glans (G), coronal sulcus (COS), and foreskin (F) with 24, 4, a nd 12 histologic sections each. Four types of carcinomas were found: ( a) superficially spreading (42%), a biphasic infiltrating and extensiv e carcinoma in situ usually involving more than one compartment and ra dially growing along the surface of G, BPS, F, or even urethra; (b) ve rtical growth (32%), unifocal high-grade, deeply invasive neoplasms wi th minimal or no carcinoma in situ component; (c) verrucous (18%), low -grade papillary or endophytic; and (d) multicentric (8%), two or more independent primary tumors separated by non-neoplastic mucosa. Inguin al lymph node metastasis were found in 82, 42, and 33% of pathologic t ypes vertical growth, superficially spreading, and multicentric carcin omas, respectively; verrucous tumors did not show metastasis. The morp hologic diversity of penile cancer may be related to different causati ve factors. Metastatic involvement suggests a distinctive biological b ehavior of the tumor. The widespread extension of superficially spread ing and multicentric carcinomas to anatomical compartments indicate pe nile mucosa as one ''field'' prone to malignant transformation. These findings may be important for the selection of appropriate therapy and emphasize the need for a close follow-up of patients undergoing less than a complete removal of the three compartments.