Universidad Nacional de Asuncion | Medicina

Background: Five cases of clear cell carcinoma of the foreskin have been reported and are thought to be originated from sweat glands at that site (Am J Surg Path 2004). Here we report 3 cases of clear cell squamous cell carcinomas arising... more

Background: Five cases of clear cell carcinoma of the foreskin have been reported and are thought to be originated from sweat glands at that site (Am J Surg Path 2004). Here we report 3 cases of clear cell squamous cell carcinomas arising in the penile glans epithelium.
Design: Clinical and pathological features were evaluated. An average of 15 sections per case was studied. Immunohistochemical stains were GATA 3, cytokeratin 7, cytokeratin 19 and p16. HPV detection by whole tissue (WTS)-PCR was done in one case.
Results: Patients’ ages were 52, 88 and 95 years. Tumors were large (Average: 6.1 cm) and involved glans and sulcus in all cases; foreskin was partially compromised in one case. Microscopically clear cells predominated (>95%). Growth was in solid nests some with comedo-like necrosis. Geographical necrosis was present. Cells were non-keratinizing with a clear cytoplasm. Nuclei were irregular, with numerous mitoses. Focal invasive warty-basaloid or basaloid features were present in 2 cases, both showing warty or basaloid PeIN. There was invasion of corpora cavernosa, lymphatics, veins and perineural spaces. p16 was positive in all 3 cases while CK 7 and CK 19 were positive in only 1 case. GATA 3 stain was negative in the 3 cases. HPV 16 was detected in one. Clinical groin metastases were present in the 3 cases, and pathologically confirmed in one. The youngest patient of the series died from tumor dissemination 12 months after penectomy. The remainder two (recent patients) refused lymph node surgical excision and are alive with disease.
Conclusions: We are reporting 3 morphologically distinctive aggressive penile tumors with prominent clear cell features originating in the glans surface squamous epithelium. The differential diagnosis includes metastatic renal cell carcinoma and sweat gland carcinoma of the shaft, which were previously reported. Features that favour the diagnosis of primary penile clear cell carcinoma are tumor location on the glans mucosa, presence of concomitant warty-basaloid PeIN, and HPV/p16 positivity.

Penile clear cell carcinoma originating in skin adnexal glands has been previously reported. Here, we present 3 morphologically distinctive penile tumors with prominent clear cell features originating not in the penile skin but in the... more

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- by Diego Fernando Sánchez Martínez
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- 2
  Pathology, Surgical Oncology

A third to half of penile invasive squamous cell carcinomas are human papillomavirus (HPV) related. Warty (condylomatous), warty-basaloid, and basaloid carcinomas are the most common subtypes associated with HPV. Less frequent are clear... more

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- by Diego Fernando Sánchez Martínez
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- 2
  Pathology, Surgical Oncology

The majority of penile carcinomas are squamous cell carcinomas originating in the squamous mucosa covering the glans, coronal sulcus, or inner surface of the foreskin, the 3 latter sites comprising the penile anatomical compartments.... more

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- by Diego Fernando Sánchez Martínez
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- 2
  Pathology, Surgical Oncology

Pathologists' contribution in the determination of prognosis in invasive penile squamous cell carcinoma is crucial. The TNM staging system is based on the identification of pathological data. There are multiple pathologically based... more

Pathologists' contribution in the determination of prognosis in invasive penile squamous cell carcinoma is crucial. The TNM staging system is based on the identification of pathological data. There are multiple pathologically based factors believed to be important in relation to the rates of regional inguinal lymph node and specific cancer death. Among them are tumor site, size, histological subtypes, thickness or anatomical level of invasion, tumor front, and vascular or perineural invasion. The identification of these factors determines the prognostic profile of patients with penile cancer. These factors are used for the construction of pathological risk groups, prognostic index, or nomograms and are helpful in the prediction of nodal metastasis or patients' outcome. This review will describe in detail the influential pathological prognostic factors present in each tumor category emphasizing the impact of especial histological subtypes in tumor spread and final outcome. There are few studies comprehensibly addressing the relation of tumor morphology and prognosis according to histological types. We are summarizing findings of prognostic factors in 3 different series for the most common types and individual series in more recently described tumor entities. We had found a broad correlation of special subtypes of penile squamous cell carcinomas that made regional nodal status and final outcome predictable according to histological features of the tumor. These findings permitted grouping special subtypes of squamous cell carcinomas into prognosis risk groups of low, intermediate, and high. In the first category of excellent prognoses are the usual grade I, verrucous, papillary NOS, pseudohyperplastic and cuniculatum carcinomas. In the second group, there are the grade II usual, mixed and warty carcinomas. The third category of tumors, with the worst prognosis is composed of high grade usual, basaloid, warty-basaloid, papillary basaloid, and sarcomatoid carcinomas. We found that subtyping of penile squamous cell carcinoma is important to determine risk for nodal metastasis and patients' survival.

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- by Antonio Cubilla and +1
  Diego Fernando Sánchez Martínez
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- 2
  Pathology, Surgical Oncology

Background: The prognostic spectrum of penile carcinomas, variable from excellent to dismal, is in part related to the histological architecture of the various tumors. Design: 126 Patients had penectomies and bilateral groin dissections... more

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- by Diego Fernando Sánchez Martínez
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In depth exploration of genomes structure and function has revealed a central role for non-coding RNAs (ncRNAs) in orchestrating key biological and cellular processes through the fine tuning of gene expression. Most importantly a role for... more

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- by Diego Fernando Sánchez Martínez
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- 5
  Bioinformatics, Molecular Biology, Genomics, Cancer

Blepharitis is a very common disease in the ophthalmologic practice generally taking a chronic course with intermittent exacerbations. Several studies have linked the presence of Demodex folliculorum with chronic blepharitis, since the... more

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- by martin arrua
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- 14
  Paraguay, Adolescent, Humans, Chronic Disease

Enfermedades Reumatologicas INTRODUCCIÓN • Especialidad dedicada a trastornos médicos del aparato locomotor y tejido conectivo • Abarca gran número de enfermedades • Mayoría de etiología desconocida, fisiopatología confusa y frecuente... more

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