Analysis of alterations adjacent to invasive squamous cell carcinoma of the penis and their relationship with associated carcinoma

Renaud-Vilmer, Catherine; Cavelier-Balloy, Benedicte; Verola, Olivier; Morel, Patrice; Servant, Jean Marie; Desgrandchamps, François; Dubertret, Louis

doi:10.1016/j.jaad.2009.06.087

« Previous Next »Journal of the American Academy of Dermatology
Volume 62, Issue 2 , Pages 284-290, February 2010

Analysis of alterations adjacent to invasive squamous cell carcinoma of the penis and their relationship with associated carcinoma

Catherine Renaud-Vilmer, MD
- Department of Dermatology, Hôpital Saint-Louis, Paris, France
- Department of Dermatology, Centre anti-cancéreux René Huguenin, St Cloud, France
- Reprint requests: Catherine Renaud-Vilmer, MD, Service de Dermatologie du Professeur Dubertret, Hôpital Saint-Louis, 1 Avenue Claude Vellefaux, 75475 Paris Cedex 10, France.
Benedicte Cavelier-Balloy, MD
- Department of Dermatology, Hôpital Saint-Louis, Paris, France
- Department of Pathology, Hôpital Saint-Louis, Paris, France
Olivier Verola, MD
- Department of Pathology, Hôpital Saint-Louis, Paris, France
Patrice Morel, MD
- Department of Dermatology, Hôpital Saint-Louis, Paris, France
Jean Marie Servant, MD
- Department of Plastic Surgery, Hôpital Saint-Louis, Paris, France
François Desgrandchamps, MD
- Department of Urology, Hôpital Saint-Louis, Paris, France
Louis Dubertret, MD
- Department of Dermatology, Hôpital Saint-Louis, Paris, France

Background

In contrast to vulvar squamous cell carcinoma (SCC), the etiologic factors and precancerous lesions associated with penile carcinoma remain uncertain.

Objectives

To describe the morphologic features of lesions adjacent to invasive penile SCC and their relationship with the associated carcinoma and to compare these associations with vulvar carcinoma.

Methods

This was a retrospective histologic analysis of 68 cases of penile SCC. Adjacent lesions were considered to be premalignant lesions. They were classified as penile intraepithelial neoplasia (PIN), squamous hyperplasia (SH), and lichen sclerosus (LS). PIN cases were divided into two subtypes depending on the extension of atypia throughout the epithelium and, by analogy, with the classification of the vulvar intraepithelial neoplasia (VIN). Thus they were designated as undifferentiated (or bowenoid) PIN, defined by full-thickness atypia throughout the epithelium, and differentiated PIN, characterized by atypia confined to the lower third of the epithelium. SCC subtypes were classified as usual, verrucous, warty (condylomatous), basaloid, and mixed.

Results

Undifferentiated PIN was observed in 22 cases; LS was observed in 26 cases. Differentiated PIN and SH (except for two cases) were associated with underlying LS. Undifferentiated PIN was always associated with warty (condylomatous) (4 cases), basaloid (16 cases) or mixed SCC (2 cases), and LS with usual (19 cases) or verrucous SCC (7 cases).

Limitations

This was a retrospective analysis

Conclusion

This study suggests that, similarly to vulvar carcinoma, penile SCC occurs in association with two types of penile lesions: undifferentiated (or bowenoid) PIN and LS-linked differentiated PIN and/or SH. It appears that the subtype of these carcinomas is related to these adjacent lesions.

Key words: penile carcinoma, penile intra-epithelial neoplasia lichen sclerosus, penile pre-cancerous lesions

Abbreviations used: HPV, human papillomavirus, LS, lichen sclerosus, PIN, penile intraepithelial neoplasia, SCC, squamous cell carcinoma, SH, squamous hyperplasia, SIL, squamous intraepithelial lesion, VIN, vulvar intraepithelial neoplasia