the pathology report for a patient with penile cancer

The pathology report must include the anatomical site of the primary tumour, the histological type of SCC, grade, perineural invasion, depth of invasion, vascular invasion (venous/lymphatic), irregular growth and front of invasion, urethral invasion, invasion of corpus spongiosum/cavernosum, surgical margins and the p16 /HPV status (Table 6) [ 53-56 ].

Full Answer

What is the role of Pathology in the workup of penile cancer?

Handling of specimens and histopathological typing must be performed by experienced pathologists according to recent developments in the pathogenesis, classification, and therapeutic strategies of penile cancer.

What are the risk factors for penile cancer?

Table 1: Recognised aetiological and epidemiological risk factors for penile cancer Human papilloma virus infection is a risk factor for penile cancer [ 34 ]. Human papilloma virus DNA has been identified in 70-100% of intra-epithelial neoplasia and in 30-40% of invasive penile cancer tissue samples

How is penile cancer treated?

Penile cancer is an aggressive disease and after systemic progression it is virtually incurable. While this squamous cell cancer responds to chemotherapy, successful treatment of lymphatic metastases can only be achieved with aggressive surgical treatment in combination with chemotherapy.

What is the prognosis of penile cancer?

Abstract. Penile cancer is an aggressive disease and after systemic progression it is virtually incurable. While this squamous cell cancer responds to chemotherapy, successful treatment of lymphatic metastases can only be achieved with aggressive surgical treatment in combination with chemotherapy.

What is the pathophysiology of penile cancer?

Two carcinogenic pathways, HPV-mediated and an HPV-independent pathway, exist for the development of penile cancer. HPV DNA has been found in up to 60–80 % of penile carcinoma, primarily basaloid and warty histologies [24].

How penile cancer is diagnosed?

Penile cancer is diagnosed with a biopsy. This is when a small sample of tissue is removed from the penis and looked at under a microscope. If the cells look like cancer cells, they will be “staged.” The TNM staging system is the system most often used.

What is the presenting symptom of penile cancer?

A rash or small crusty bumps on your penis; it can look like an unhealed scab. Growths that look bluish-brown. A lump on your penis. A bad-smelling discharge underneath your foreskin.

What is the most common histologic type of penile carcinoma?

The most prevalent histologic type was usual squamous cell carcinoma (66.9%). MVI and PVI were present in 11.2% and 4.5% of patients, respectively.

Can penile cancer be detected by blood test?

There is no specific blood test for penile cancer. Blood tests can help check your general health and different types of chemicals and protein in the blood.

What is a penile biopsy?

Penile biopsy is used to diagnose benign and malignant lesions of the penis. The technique used varies with the size and location of the lesion and may include punch biopsy or incisional/excisional biopsy.

Is penile cancer treatable?

Penile cancer often is curable if detected early. For small superficial tumors, surgery is often the best method of treatment. Minimally invasive techniques such as cryosurgery, which destroys cancer cells by freezing them, allow the surgeon to leave the surrounding healthy cells undamaged.

What is Bowen disease?

Bowen's disease is a very early form of skin cancer that's easily treatable. The main sign is a red, scaly patch on the skin. It affects the squamous cells, which are in the outermost layer of skin, and is sometimes referred to as squamous cell carcinoma in situ.

What causes penile squamous cell carcinoma?

Penile SCC has been associated with high-risk HPV infections, most commonly strains 16 and 18. The mechanism through which HPV leads to penile cancer is most likely mediated through viral oncogenes E6 and E7, which are actively transcribed by HPV-infected cells.

What is penile intraepithelial neoplasia?

Penile intraepithelial neoplasia (PeIN) is a premalignant lesion that can affect the glans, prepuce, or the shaft of the penis. On the basis of the degree of dysplasia, PeIN is divided into PeIN 1 (mild), PeIN 2 (moderate), and PeIN 3 (severe).

What is a pathology report?

A pathology report is a document that contains the diagnosis determined by examining cells and tissues under a microscope. The report may also cont...

How is tissue obtained for examination by the pathologist?

In most cases, a doctor needs to do a biopsy or surgery to remove cells or tissues for examination under a microscope. Some common ways a biopsy ca...

How is tissue processed after a biopsy or surgery? What is a frozen section?

The tissue removed during a biopsy or surgery must be cut into thin sections, placed on slides, and stained with dyes before it can be examined und...

How long after the tissue sample is taken will the pathology report be ready?

The pathologist sends a pathology report to the doctor within 10 days after the biopsy or surgery is performed. Pathology reports are written in te...

What information does a pathology report usually include?

The pathology report may include the following information ( 1 ): Patient information: Name, birth date, biopsy date Gross description: Color, weig...

What might the pathology report say about the physical and chemical characteristics of the tissue?

After identifying the tissue as cancerous, the pathologist may perform additional tests to get more information about the tumor that cannot be dete...

What information about the genetics of the cells might be included in the pathology report?

Cytogenetics uses tissue culture and specialized techniques to provide genetic information about cells, particularly genetic alterations. Some gene...

Can individuals get a second opinion about their pathology results?

Although most cancers can be easily diagnosed, sometimes patients or their doctors may want to get a second opinion about the pathology results ( 1...

What research is being done to improve the diagnosis of cancer?

NCI, a component of the National Institutes of Health, is sponsoring clinical trials that are designed to improve the accuracy and specificity of c...

What is a pathology report?

Stages of Cancer . A pathology report is a medical document that gives information about a diagnosis, such as cancer. To test for the disease, a sample of your suspicious tissue is sent to a lab. A doctor called a pathologist studies it under a microscope. They may also do tests to get more information.

What is the pathologist's job?

Microscopic description: The pathologist slices the tissue into thin layers, puts them on slides, stains them with dye, and takes a detailed look with a microscope. The pathologist notes what the cancer cells look like, how they compare to normal cells, and whether they’ve spread into nearby tissue.

What is the margin of a tumor?

Tumor margin: For the pathology sample, your surgeon took out an extra area of normal tissue that surrounds the tumor. This is called the margin. The pathologist will study this area to see if it’s free of cancer cells. There are three possible results:

What does grade mean in cancer?

Grade: The pathologist compares the cancer cells to healthy cells. There are different scales for specific cancers. A tumor grade reflects how likely it is to grow and spread. In general, this is what those grades mean: Grade 1: Low grade, or well-differentiated: The cells look a little different than regular cells.

How to grade a tumor?

Grade: The pathologist compares the cancer cells to healthy cells. There are different scales for specific cancers. A tumor grade reflects how likely it is to grow and spread. In general, this is what those grades mean: 1 Grade 1: Low grade, or well-differentiated: The cells look a little different than regular cells. They aren’t growing quickly. 2 Grade 2: Moderate grade, or moderately differentiated: They don’t look like normal cells. They’re growing faster than normal. 3 Grade 3: High grade, or poorly differentiated: The cells look very different than normal cells. They’re growing or spreading fast.

What is the mitotic rate of cancer?

They’re positive if they have cancer and negative if they don’t. Mitotic rate: This is a measure of how quickly cancerous cells are dividing. To get this number, the pathologist usually counts the number of dividing cells in a certain amount of tissue. The mitotic rate is often used to find what stage the cancer is in.

What is the stage of cancer?

Cancer stage: Staging helps your doctor decide what treatments will work best. The most common staging system is the TNM system where the T describes the original cancer, the N states if the cancer has spead to nearby lymph nodes and the M states if the cancer has spread to other parts of the body.Most cancers are assigned an overall stage with a Roman numeral I-IV (1 to 4) based on where it is and how big it is, how far it has spread, and other findings. The higher the stage, the more advanced the cancer. Some cancers have a stage 0, which means it’s an early-stage cancer that has not spread.

What is the treatment for advanced penile cancer?

Therapeutic and palliative chemotherapy in advanced penile cancer

What is the name of the drug used for penile cancer?

Sklaroff R.B., Yagoda A. (1980) Methotrexate in the treatment of penile carcinoma. Cancer45: 214–216 [PubMed] [Google Scholar]

What is the most common type of penile SCC?

The most frequent subtype of penile SCC is the ‘conventional’ SCC. Other, less common subtypes are the basaloid, verrucous, papillary, condylomatous and sarcomatoid subtypes. These differ in their apparent aetiology: while only 30–50% of conventional penile SCC subtypes are associated with human papilloma virus (HPV), almost all basaloid penile SCCs are associated with HPV [Rubin et al. 2001]. Also, some studies have shown different regulations of gene expression in different penile SCC subtypes, which may explain their different biological behaviour [Poetsch et al. 2011].

Is paclitaxel used for penile cancer?

As taxane-based chemotherapy regimens have been successfully used in SCCs of different origins, combinations incorporating paclitaxel have been used to treat patients with penile cancer from the early 2000s. A paclitaxel/carboplatin combination has been used experimentally by two groups. Bermejo and colleagues used the neoadjuvant approach in two patients and reported long-term survival after chemotherapy followed by lymph node dissection (50 versus84 months) [Bermejo et al. 2007]. Joerger and colleagues reported a ‘significant’ remission in one patient with advanced disease after three cycles of paclitaxel/carboplatin (75 mg/m2paclitaxel, area under the curve [AUC] 3 carboplatin) [Joerger et al. 2004]. Both studies reported that treatment was well tolerated.

Is penile cancer a curative disease?

Penile cancer is an aggressive disease and successful curative local treatment can usually only be achieved at an early stage. Successful treatment of advanced penile carcinoma with regional and systemic metastases remains a grave problem in uro-oncology. In regional lymphatic metastatic disease combined chemotherapy with aggressive surgical treatment may be effective but the rate of local recurrence with further progression is high. In systemic disease chemotherapy remains the only option.

Is penile cancer incurable?

Penile cancer is an aggressive disease and after systemic progression it is virtually incurable. While this squamous cell cancer responds to chemotherapy, successful treatment of lymphatic metastases can only be achieved with aggressive surgical treatment in combination with chemotherapy. However, because penile carcinoma is relatively rare there is a paucity of clinical data on the chemotherapy for this aggressive disease. Recent advances have included the establishment of less toxic regimens incorporating taxanes, while cisplatinum remains central to all regimens. Multi-institutional studies are urgently needed to advance the multimodal care for patients with penile cancer.

Is there a second line for penile cancer?

There are again virtually no data on second-line strategies for the systemic treatment of penile cancer. Recently, Di Lorenzo and colleagues reported the results of a phase II trial of 25 patients with progression after pretreatment with different chemotherapy regimens treated with a single agent paclitaxel [Di Lorenzo et al. 2011]. They observed a response in five of 25 patients, with grade 4 neutropenia reported in seven patients and a median progression-free survival of 11 weeks (median overall survival 23 weeks).

Definition of Penile Cancer

Epidemiology

Risk Factors and Prevention

Pathology

• Squamous cell carcinoma accounts for over 95% of penile malignancies (see Table 1). It is not known how often SCC is preceded by premalignant lesions (see Table 4) [47-50]. Different histological types of penile SCC with different growth patterns, clinical aggressiveness and HPV associations have been identified (see Table 5). Numerous mixed forms ...

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