Clinicopathologic Features and Human Papillomavirus DNA Prevalence of Warty and Squamous Cell Carcinoma of the Penis

Abstract

Squamous cell carcinoma (SCC) accounts for 95% of penile malignant neoplasms. A subtype of SCC, named warty carcinoma (WC), is a morphologically distinct verruciform tumor with features of human papillomavirus (HPV)-related lesions. Descriptions of the behavior and histologic features of this tumor are scarce in the literature. The aim of this report is to analyze the clinicopathologic features and HPV deoxyribonucleic acid status in 60 SCCs and 11 WCs. The mean patient age was 46.5 +/- 15.9 years for WC and 52.6 +/- 12.4 years for SCC. No significant differences in age (p = 0.154) and clinical staging (T, p = 0.649; N, p = 0.497) between the two groups of tumors were found. When compared with SCCs, WCs exhibited less lymphatic embolization (p = 0.001), nodal metastasis (p = 0.019), and corpora cavernosa and corpus spongiosum infiltration (p = 0.040). Lymph node metastases were found in 34 of 60 SCC patients (56.7%) and in two of 11 WC patients (18.2%). No patients with WC tumors died of the disease compared with 19 of 60 (5-year specific survival, 66.0%) in the SCC group (p = 0.032). HPV deoxyribonucleic acid was more likely to be associated with WC (five of 11, 45.5%) than SCC (16 of 60, 26.7%), although significance was not reached (p = 0.209). The results suggest that WC is less aggressive and confers a better prognosis than typical SCC of the penis.

Identification and genotyping of human papillomavirus in a Spanish cohort of penile squamous cell carcinomas: Correlation with pathologic subtypes, p16INK4a expression, and prognosis

“…1 HPV-18 represents the second most prevalent HPV type in PSCC in countries such as Thailand and Brazil, 29-31 but its detection is uncommon in European countries. In contrast to other studies detecting multiple HPV subtypes in a significant number of cases (from 20%-50%), 12,16,31,32 we have observed such phenomenon in only 6.5% of cases. The significance of multiple HPV subtypes is not fully understood, and the potential role of the different detected HPVs as carcinogens or coinfectors has not been elucidated.…”

Risk Factors for Squamous Cell Carcinoma of the Penis—Population-Based Case-Control Study in Denmark

“…Theoretically, rare HPV types that were not included in the broad panel of HPV types examined might have been present in some of our negative cases. However, some subtypes of penile SCC are probably genuinely HPV negative, notably those with keratinizing SCC histology (30). Some cancers arising in the penile skin may resemble cutaneous SCCs elsewhere on the body, which are not etiologically related to HPV16 or other mucosotropic types of HPV.…”

Epidemiologic study on penile cancer in Brazil

“…There is an association between Human Papilloma Virus (HPV) infection and penile cancer in 30 to 50% of cases, primarily HPV 16 (9), although the exact role of the infection in the genesis of this neoplasia has not yet been entirely clarified (10).…”