Penile warty mucoepidermoid carcinoma with features of stratified mucin-producing intra-epithelial lesion and invasive stratified mucin-producing carcinoma

Kenji Yorita, Naoto Kuroda, Takushi Naroda, Masato Tamura, Chisato Ohe, Mukul Divatia, Mahul Amin, Antonio L. Cubilla, Dimitry V. Kazakov, Ondrej Hes, Michael Michal, Michal Michal

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Abstract

Aims: Stratified mucin-producing intra-epithelial lesion (SMILE) and invasive stratified mucin-producing carcinoma (ISMC) are recently described cervical and penile lesions. We report an unusual case of mixed variant of penile squamous cell carcinomas with warty, usual and mucoepidermoid SMILE/ISMC features. Methods and results: A 62-year-old Japanese man had a glans penis lesion of one-and-a-half years’ duration, suggesting malignancy. Partial penectomy and left inguinal lymphadenectomy were performed. Pathological evaluation revealed a mixed squamous cell carcinoma with warty, mucinous and usual features. The mucinous component resembled mucoepidermoid carcinoma (MEC) and SMILE/ISMC. Glandular differentiation was absent. All the diverse tumour components were negative for p16, which was confirmed by negative human papillomavirus (HPV) genotyping. The mucinous component was diffusely positive for cytokeratin 7 and largely negative for cytokeratin 5 and p63. Fluorescence in-situ hybridisation did not detect rearrangement in the MAML2 or EWSR1 genes. The tumour was pathological stage pT2, pN1 (AJCC prognostic stage group IIIA) and was disease-free 26 months after surgery. Conclusions: The lack of glands in the mucinous areas suggested that MEC should be separated from adenosquamous carcinoma (ASC). Penile SMILE/ISMC may occur without dependence upon HPV status. Further studies will be necessary to determine the pathogenesis and definition of penile SMILE/ISMC, the presence of true MEC arising from the glans penis and the clinicopathological differences of penile ASC, MEC and SMILE/ISMC. Herein, we refer to the SMILE-like penile lesion as ‘mucinous penile intra-epithelial neoplasia’.

Original languageEnglish (US)
Pages (from-to)867-873
Number of pages7
JournalHistopathology
Volume72
Issue number5
DOIs
StatePublished - Apr 1 2018

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Mucoepidermoid Carcinoma
Mucins
Carcinoma
Adenosquamous Carcinoma
Penis
Squamous Cell Carcinoma
Neoplasms
Keratin-5
Keratin-7
Groin
Lymph Node Excision
Fluorescence In Situ Hybridization

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine
  • Histology

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Penile warty mucoepidermoid carcinoma with features of stratified mucin-producing intra-epithelial lesion and invasive stratified mucin-producing carcinoma. / Yorita, Kenji; Kuroda, Naoto; Naroda, Takushi; Tamura, Masato; Ohe, Chisato; Divatia, Mukul; Amin, Mahul; Cubilla, Antonio L.; Kazakov, Dimitry V.; Hes, Ondrej; Michal, Michael; Michal, Michal.

In: Histopathology, Vol. 72, No. 5, 01.04.2018, p. 867-873.

Research output: Contribution to journalArticle

Yorita, K, Kuroda, N, Naroda, T, Tamura, M, Ohe, C, Divatia, M, Amin, M, Cubilla, AL, Kazakov, DV, Hes, O, Michal, M & Michal, M 2018, 'Penile warty mucoepidermoid carcinoma with features of stratified mucin-producing intra-epithelial lesion and invasive stratified mucin-producing carcinoma', Histopathology, vol. 72, no. 5, pp. 867-873. https://doi.org/10.1111/his.13438
Yorita, Kenji ; Kuroda, Naoto ; Naroda, Takushi ; Tamura, Masato ; Ohe, Chisato ; Divatia, Mukul ; Amin, Mahul ; Cubilla, Antonio L. ; Kazakov, Dimitry V. ; Hes, Ondrej ; Michal, Michael ; Michal, Michal. / Penile warty mucoepidermoid carcinoma with features of stratified mucin-producing intra-epithelial lesion and invasive stratified mucin-producing carcinoma. In: Histopathology. 2018 ; Vol. 72, No. 5. pp. 867-873.
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abstract = "Aims: Stratified mucin-producing intra-epithelial lesion (SMILE) and invasive stratified mucin-producing carcinoma (ISMC) are recently described cervical and penile lesions. We report an unusual case of mixed variant of penile squamous cell carcinomas with warty, usual and mucoepidermoid SMILE/ISMC features. Methods and results: A 62-year-old Japanese man had a glans penis lesion of one-and-a-half years’ duration, suggesting malignancy. Partial penectomy and left inguinal lymphadenectomy were performed. Pathological evaluation revealed a mixed squamous cell carcinoma with warty, mucinous and usual features. The mucinous component resembled mucoepidermoid carcinoma (MEC) and SMILE/ISMC. Glandular differentiation was absent. All the diverse tumour components were negative for p16, which was confirmed by negative human papillomavirus (HPV) genotyping. The mucinous component was diffusely positive for cytokeratin 7 and largely negative for cytokeratin 5 and p63. Fluorescence in-situ hybridisation did not detect rearrangement in the MAML2 or EWSR1 genes. The tumour was pathological stage pT2, pN1 (AJCC prognostic stage group IIIA) and was disease-free 26 months after surgery. Conclusions: The lack of glands in the mucinous areas suggested that MEC should be separated from adenosquamous carcinoma (ASC). Penile SMILE/ISMC may occur without dependence upon HPV status. Further studies will be necessary to determine the pathogenesis and definition of penile SMILE/ISMC, the presence of true MEC arising from the glans penis and the clinicopathological differences of penile ASC, MEC and SMILE/ISMC. Herein, we refer to the SMILE-like penile lesion as ‘mucinous penile intra-epithelial neoplasia’.",
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T1 - Penile warty mucoepidermoid carcinoma with features of stratified mucin-producing intra-epithelial lesion and invasive stratified mucin-producing carcinoma

AU - Yorita, Kenji

AU - Kuroda, Naoto

AU - Naroda, Takushi

AU - Tamura, Masato

AU - Ohe, Chisato

AU - Divatia, Mukul

AU - Amin, Mahul

AU - Cubilla, Antonio L.

AU - Kazakov, Dimitry V.

AU - Hes, Ondrej

AU - Michal, Michael

AU - Michal, Michal

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N2 - Aims: Stratified mucin-producing intra-epithelial lesion (SMILE) and invasive stratified mucin-producing carcinoma (ISMC) are recently described cervical and penile lesions. We report an unusual case of mixed variant of penile squamous cell carcinomas with warty, usual and mucoepidermoid SMILE/ISMC features. Methods and results: A 62-year-old Japanese man had a glans penis lesion of one-and-a-half years’ duration, suggesting malignancy. Partial penectomy and left inguinal lymphadenectomy were performed. Pathological evaluation revealed a mixed squamous cell carcinoma with warty, mucinous and usual features. The mucinous component resembled mucoepidermoid carcinoma (MEC) and SMILE/ISMC. Glandular differentiation was absent. All the diverse tumour components were negative for p16, which was confirmed by negative human papillomavirus (HPV) genotyping. The mucinous component was diffusely positive for cytokeratin 7 and largely negative for cytokeratin 5 and p63. Fluorescence in-situ hybridisation did not detect rearrangement in the MAML2 or EWSR1 genes. The tumour was pathological stage pT2, pN1 (AJCC prognostic stage group IIIA) and was disease-free 26 months after surgery. Conclusions: The lack of glands in the mucinous areas suggested that MEC should be separated from adenosquamous carcinoma (ASC). Penile SMILE/ISMC may occur without dependence upon HPV status. Further studies will be necessary to determine the pathogenesis and definition of penile SMILE/ISMC, the presence of true MEC arising from the glans penis and the clinicopathological differences of penile ASC, MEC and SMILE/ISMC. Herein, we refer to the SMILE-like penile lesion as ‘mucinous penile intra-epithelial neoplasia’.

AB - Aims: Stratified mucin-producing intra-epithelial lesion (SMILE) and invasive stratified mucin-producing carcinoma (ISMC) are recently described cervical and penile lesions. We report an unusual case of mixed variant of penile squamous cell carcinomas with warty, usual and mucoepidermoid SMILE/ISMC features. Methods and results: A 62-year-old Japanese man had a glans penis lesion of one-and-a-half years’ duration, suggesting malignancy. Partial penectomy and left inguinal lymphadenectomy were performed. Pathological evaluation revealed a mixed squamous cell carcinoma with warty, mucinous and usual features. The mucinous component resembled mucoepidermoid carcinoma (MEC) and SMILE/ISMC. Glandular differentiation was absent. All the diverse tumour components were negative for p16, which was confirmed by negative human papillomavirus (HPV) genotyping. The mucinous component was diffusely positive for cytokeratin 7 and largely negative for cytokeratin 5 and p63. Fluorescence in-situ hybridisation did not detect rearrangement in the MAML2 or EWSR1 genes. The tumour was pathological stage pT2, pN1 (AJCC prognostic stage group IIIA) and was disease-free 26 months after surgery. Conclusions: The lack of glands in the mucinous areas suggested that MEC should be separated from adenosquamous carcinoma (ASC). Penile SMILE/ISMC may occur without dependence upon HPV status. Further studies will be necessary to determine the pathogenesis and definition of penile SMILE/ISMC, the presence of true MEC arising from the glans penis and the clinicopathological differences of penile ASC, MEC and SMILE/ISMC. Herein, we refer to the SMILE-like penile lesion as ‘mucinous penile intra-epithelial neoplasia’.

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