Penile squamous neoplasia

Penile squamous neoplasia 

Updated: 01/03/2023

© Jun Wang, MD, PhD

Penile intraepithelial neoplasia (PeIN)
  • Rare, precancerous lesion
  • HPV associated
  • Usually whitish discoloration with erythematous changes and ulceration
  • Four variants
    • Differentiated: Most common, more mature, atypia at bottom layers
    • Basaloid: Monotonous small to intermediate sized cells
    • Warty: Papillary growth with koilocytes
    • Warty basaloid: Papillary growth with basaloid cells in middle and lower third of epithelium
  • Common in HIV+ men with anal dysplasia
  • Treatment: Laser, surgery
Bowen’s disease
Squamous cell carcinoma
Verrucous carcinoma
  • Extremely well-differentiated variant of squamous cell carcinoma
  • Most common at glans, usually HPV negative
  • Very well-differentiated with prominent intercellular bridges, minimal atypia
  • Broad base and pushing borders
  • Usually do NOT overexpress p16
  • Treatment: Surgery
  • Usually excellent prognosis, may recur

Bowenoid papulosis
  • Term no longer used by pathologists, replaced with PeIN
  • More common in sexually active young males
  • Associated with HPV 16 or 18
  • Usually regress spontaneously
  • May progress to cancer
  • Multiple soft papules, most commonly in the skin of the shaft
  • Histologically similar to Bowen’s disease, but less severe atypia



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Contents

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