Editing EAU & ASCO: Penile Cancer 2023 (section)

== Pathology ==
* '''<span style="color:#ff0000">>95% of penile cancers are squamous cell carcinomas (SCCs)'''
* '''Other malignant lesions of the penis'''
** '''Melanoma'''
** '''Mesenchymal tumors'''
** '''Lymphomas'''
** '''Metastases'''
*** '''Penile metastases are frequently of prostatic, urinary bladder or colorectal origin'''
**'''Sarcoma'''

=== Penile Squamous Cell Carcinoma ===

* '''<span style="color:#ff0000">Usually arises from the epithelium of the inner foreskin/prepuce or the glans'''

==== Classification ====
* '''<span style="color:#ff0000">HPV-independent'''
** Usual
** Pseudohyperplastic
** Pseudoglandular
** Verrucous
** Caniculatum
** Papillary
** Sarcomatoid (Most aggressive and worse prognosis)
** Mixed
* '''<span style="color:#ff0000">HPV-associated'''
** Basaloid (most common among HPV-associated penile carcinomas)
** Warty
** Clear cell
** Lymphoepithelioma-like
** Mixed

==== Grading ====
* The tumour, node, metastasis (TNM) classification for penile cancer includes tumour grade based on its prognostic relevance
* Highly observer-dependent and can be problematic, especially in large tumours which may be heterogeneous
* Based on
** Cytological atypica
** Keratinisation
** Intercellular bridges
** Mitotic activity
** Tumour margin
* '''Classification (4)'''
** '''Grade 1'''
** '''Grade 2'''
** '''Grade 3'''
** '''Sarcomatoid'''
*** '''Grade 3 and sarcomatoid are considered poorly differentiated'''

==== Penile intraepithelial neoplasia (PeIN) ====

* '''<span style="color:#ff0000">Considered the precursor lesion of penile SCC'''
* '''Clinical terms such as ‘Erythroplasia of Queyrat, Bowenoid papulosis and Bowen’s disease’ are discouraged'''
*Also classified as HPV-independent and HPV-associated