Dos Santos Joana, Cabrebra Rafael, Neves Beatriz, Silva Eduardo, Polónia António
Unidade Local de Saúde de Matosinhos (ULSM), Department of Pathology, Matosinhos, Porto, Portugal.
Instituto Português de Oncologia de Lisboa (IPO Lisboa), Department of Pathology, Lisboa, Lisboa, Portugal.
Autops Case Rep. 2021 Aug 20;11:e2021303. doi: 10.4322/acr.2021.303. eCollection 2021.
Malignant tumors of the penis are rare, most of them being squamous cell carcinomas (SCCs). We report the case of a 75-year-old man with a large penile mass submitted to partial penectomy. The specimen showed an exophytic mass involving the glans, coronal sulcus, and prepuce. Microscopic examination showed a carcinoma with two distinct areas: a mixed SCC and a sarcomatoid carcinoma. The SCC component had areas of verrucous carcinoma and areas of classical invasive SCC. The tumor cells expressed p63 with the absence of p16 expression. Vimentin and p53 were positive in the sarcomatous component. The morphology and immunohistochemistry were compatible with mixed SCC (verrucous hybrid-sarcomatoid carcinoma). Additionally, the tumor cells also expressed 3 different clones of PDL1 (22C3, SP263, and SP142). Two months later, the patient presented local recurrence with multiple lymph nodes and lung metastases, dying 7 weeks later. Mixed tumors represent diagnostic challenges. The correct identification of adverse prognostic factors can be the first step to implement the treatment with a higher probability of success.
阴茎恶性肿瘤罕见，其中大多数为鳞状细胞癌（SCC）。我们报告一例75岁男性，因阴茎巨大肿物接受了部分阴茎切除术。标本显示为外生性肿物，累及龟头、冠状沟和包皮。显微镜检查显示为一种具有两个不同区域的癌：混合性SCC和肉瘤样癌。SCC成分有疣状癌区域和经典浸润性SCC区域。肿瘤细胞表达p63，而p16无表达。波形蛋白和p53在肉瘤样成分中呈阳性。形态学和免疫组化结果符合混合性SCC（疣状混合型-肉瘤样癌）。此外，肿瘤细胞还表达3种不同克隆的PDL1（22C3、SP263和SP142）。两个月后，患者出现局部复发并伴有多发淋巴结和肺转移，7周后死亡。混合性肿瘤带来诊断挑战。正确识别不良预后因素可能是实施更有可能成功的治疗的第一步。
