Papillary Carcinoma



Papillary Carcinoma


Antonio L. Cubilla, MD

Alcides Chaux, MD

Elsa F. Velazquez, MD










Low-power view of papillary SCC depicts the typical papillomatous pattern of growth with irregular and complex papillae and jagged tumor-stroma interface image with a prominent stromal reaction.






Histological features of the papillae include presence of mild acanthosis with moderate cytologic atypia, slight hyper- and parakeratosis, and no koilocytic changes in the epithelium.


TERMINOLOGY


Abbreviations



  • Squamous cell carcinoma (SCC)


Synonyms



  • Papillary carcinoma, NOS


Definitions



  • Low-grade malignant epithelial tumor with typical exophytic pattern of growth


  • Diagnosis is made only after exclusion of other verruciform tumors


  • Represents 5-15% of all penile SCC


  • Accounts for 27-53% of all verruciform tumors


ETIOLOGY/PATHOGENESIS


Etiologic Factors



  • Etiology unknown but frequently associated with lichen sclerosus


  • Evidence of human papillomavirus (HPV) infection found in minority of cases


CLINICAL ISSUES


Epidemiology



  • Age



    • Average age is 63 years (range from 43-85 years)


Presentation



  • Granular and firm cauliflower-like exophytic tumor


Treatment



  • Partial penectomy as primary treatment


  • Inguinal lymphadenectomy according to risk group stratification


Prognosis



  • Less aggressive than usual SCC



    • Recurrence rate of about 1/10, usually due to insufficient surgery


    • Inguinal metastases are found in about 1/10 of patients


    • Cancer-specific mortality rate very low


  • Similar to other verruciform tumors in biological behavior


MACROSCOPIC FEATURES


General Features



  • Tumors present exophytic verruciform pattern of growth



    • Glans is most frequently affected anatomical compartment


    • Foreskin exclusively affected in minority of cases


  • Extension to multiple anatomical compartments in up to 50% of cases


  • Average size = 4.5-5.8 cm


  • Cut surface depicts serrated tumoral base


  • Poorly defined tumor-stroma interface


  • Invasion of penile erectile tissues is common

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