Mixed Carcinoma



Mixed Carcinoma


Antonio L. Cubilla, MD

Alcides Chaux, MD

Elsa F. Velazquez, MD










Diagram of a mixed penile tumor depicts a low-grade superficial exophytic tumor image, corresponding to a verrucous carcinoma, and a focus of deeply infiltrating high-grade usual SCC image.






Hybrid verrucous carcinoma shows concomitant presence of low-grade verrucous carcinoma with its typical bulbous tumor base image intermingled with solid nests of a high-grade usual SCC image.


TERMINOLOGY


Abbreviations



  • Squamous cell carcinoma (SCC)


Definitions



  • Coexistence of 2 or more histologic subtypes


  • 20% or more of at least 1 of the histologic components


CLINICAL ISSUES


Epidemiology



  • Incidence



    • Represents 1/3 of all penile SCC


  • Age



    • Mean age: 56 years old


Site



  • Glans is most frequently affected site


  • Foreskin location is uncommon


Treatment



  • Depends mainly on local extent and histologic grade of tumor


  • Surgical approach should be considered for tumors invading beyond lamina propria


  • Groin dissection should be performed based on risk group stratification


Prognosis



  • Related to higher grade component


  • Clinical behavior is variable in concordance with histologic picture and relative proportion of different components


  • Local and regional recurrences may occur


  • Inguinal nodal involvement is rarely seen


  • Cancer-specific mortality rate is low


MACROSCOPIC FEATURES


General Features



  • Gross appearance is variable


  • Mixed patterns of growth are common


  • Verruciform and superficial spreading patterns correspond to low-grade tumors


  • Vertical growth pattern is observed in high-grade tumors


  • Multicentricity is not uncommon


  • Average tumor size: 4.1 cm


MICROSCOPIC PATHOLOGY


Histologic Features

Jul 7, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Mixed Carcinoma
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