title: Basaloid squamous cell carcinoma of the penis with papillary features:  a clinicopathologic study of 12 cases.
abstract: There are 3 distinct variants of penile squamous cell carcinoma frequently associated with human papillomavirus (HPV): basaloid, warty-basaloid, and warty carcinomas. Considering the high incidence rates of penile cancer in some countries, a large international study was designed to evaluate the presence of HPV, its genotype distribution, and its association with histologic types of penile cancer. In this international review of >900 cases, we found a group of highly distinct papillary neoplasms composed of basophilic cells resembling urothelial tumors but frequently associated with HPV. Macroscopically, tumors were exophytic or exoendophytic. Microscopically, there was a papillomatous pattern of growth with a central fibrovascular core and small basophilic cells lining the papillae. Positivity for HPV was present in 11 of 12 tumors (92%). Single genotypes found were HPV-16 in 9 tumors and HPV-51 in 1 tumor. Multiple genotypes (HPV-16 and HPV-45) were present in another case. Overexpression of p16 was observed in all cases. Uroplakin-III was negative in all cases. The differential diagnosis was with basaloid, warty-basaloid, warty, and papillary squamous cell carcinoma and with urothelial carcinomas. Local excision (4 cases), circumcision (3 cases), or partial penectomy (5 cases) were preferred treatment choices. Tumor thickness ranged from 1 to 15 mm (average, 7 mm). Two patients with tumors invading 11 and 15 mm into the corpus spongiosum developed inguinal nodal metastasis. Of 11 patients followed up (median 48 mo), 7 were alive with no evidence of metastatic disease, 3 died from causes other than penile cancer, and another died postoperatively. This morphologically distinct tumor probably represents a papillary variant of basaloid carcinomas (papillary-basaloid carcinomas). Unlike typical basaloid carcinomas, the overall prognosis was excellent. However, deeply invasive tumors were associated with regional nodal metastasis indicating a potential for tumor-related death.
authors.affiliation: Instituto de Patología e Investigación, Universidad Nacional de Asunción, Asunción, Paraguay. antoniocubillaramos@gmail.com
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Cubilla
authors.forename: Belén
authors.initials: B
authors.lastname: Lloveras
authors.forename: Laia
authors.initials: L
authors.lastname: Alemany
authors.forename: María
authors.initials: M
authors.lastname: Alejo
authors.forename: August
authors.initials: A
authors.lastname: Vidal
authors.forename: Elena
authors.initials: E
authors.lastname: Kasamatsu
authors.forename: Omar
authors.initials: O
authors.lastname: Clavero
authors.forename: Isabel
authors.initials: I
authors.lastname: Alvarado-Cabrero
authors.forename: Charles
authors.initials: C
authors.lastname: Lynch
authors.forename: Julio
authors.initials: J
authors.lastname: Velasco-Alonso
authors.forename: Annabelle
authors.initials: A
authors.lastname: Ferrera
authors.forename: Alcides
authors.initials: A
authors.lastname: Chaux
authors.forename: Joellen
authors.initials: J
authors.lastname: Klaustermeier
authors.forename: Wim
authors.initials: W
authors.lastname: Quint
authors.forename: Silvia
authors.initials: S
authors.lastname: de Sanjosé
authors.forename: Nubia
authors.initials: N
authors.lastname: Muñoz
authors.forename: Francisco Xavier
authors.initials: FX
authors.lastname: Bosch
mesh_terms: D000231:Adenocarcinoma, Papillary / Q000378:metabolism / Q000473:pathology* / Q000628:therapy / Q000821:virology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D052685:Alphapapillomavirus / Q000235:genetics / Q000302:isolation & purification; D014408:Biomarkers, Tumor / Q000378:metabolism; D003131:Combined Modality Therapy; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D018307:Neoplasms, Squamous Cell / Q000378:metabolism / Q000473:pathology* / Q000628:therapy / Q000821:virology; D030361:Papillomavirus Infections / Q000378:metabolism / Q000473:pathology* / Q000821:virology; D010412:Penile Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000628:therapy / Q000821:virology
chemical_list: D014408:Biomarkers, Tumor; D019941:Cyclin-Dependent Kinase Inhibitor p16