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EAU & ASCO: Penile Cancer 2023
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=== 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
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