Penile hybrid verrucous-squamous carcinoma associated with a superficial inguinal lymph node metastasis

A 62-year-old Japanese man who presented with penile carcinoma is reported. The initial exophytic neoplasm excised from the coronal sulcus and prepuce on the abdominal side of the penis was diagnosed histologically as verruco us carcinoma. Twenty-six months after the primary operation, an epithelial neoplasm recurred within the scar of the primary operation. The neoplasm hi stologically showed verrucous carcinoma and multiple invasive foci of conve ntional squamous cell carcinoma in the advancing edge of the tumor, as such representing a hybrid verrucous-squamous carcinoma. A lymph node metastasi s in the left superficial inguinal lymph node occurred 4 months after the s econd operation. A total bilateral inguinal lymphadenectomy was performed a nd revealed no other lymph node metastases. The patient is alive without lo cal recurrence or evidence of metastases in pelvic lymph nodes or visceral organs 2 years after the resection of the hybrid verrucous-squamous carcino ma, The initial verrucous carcinoma, recurrent hybrid verrucous-squamous ca rcinoma, and metastatic lymph node were negative for human papillomavirus D NA type 6, 11, 16, 18, and 33 sequences by dot blot hybridization of polyme rase chain reaction products. The characteristics of hybrid verrucous-squam ous carcinoma and importance of lymph node metastasis in penile carcinoma a re discussed.