Squamous cell carcinoma (SCC) is the most common malignant tumor of the penis. The 2022 WHO classification reinforces the 2016 classification and subclassifies precursor lesions and tumors into HPV-associated and HPV-independent types. HPV-associated Penile intraepithelial neoplasia (PeIN) is a precursor lesion of invasive HPV- associated SCC, whereas differentiated PeIN is a precursor lesion of HPV independent SCC. Block-type positivity of p16 immunohistochemistry is the most practical daily utilizedmethod to separate HPV associated from HPV independent penile SCC. If this is not feasible, the term SCC, NOS is appropriate. Certain histologies which were previously classified as"subtypes" are now grouped, and coalesced as "patterns", under the rubric of usual type SCC and verrucous carcinoma (e.g., usual-type SCC includes pseudohyperplastic and acantholytic/ pseudoglandular carcinoma, and carcinoma cuniculatum is included as a pattern of verrucous carcinoma). If there is an additional component of the usual type of invasive SCC (formerly termed as hybrid histology), the tumour would be a mixed carcinoma (e.g., carcinoma cuniculatum or verrucous carcinoma with usual invasive SCC); in such cases, reporting of the relative percentages in mixed tumours may be useful. The consistent use of uniform nomenclature and reporting of percentages will inform the refinement of future reporting classification schemes and guidelines/recommendations. The classification of scrotal tumors is provided for the first time in the fifth edition of the WHO Blue book, and it follows the schema of penile cancer classification for both precursor lesions and the common SCC of scrotum. Basal cell carcinoma of scrotum, may have a variable clinical course and finds a separate mention.
Histopathology. 2022 Oct 11 [Epub ahead of print]
S Menon, H Moch, D M Berney, I A Cree, J R Srigley, T Tsuzuki, E Compérat, A Hartmann, G Netto, M A Rubin, A J Gill, S Turajlic, P H Tan, M R Raspollini, S K Tickoo, M B Amin
Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India., University Hospital Zurich, Department of Pathology and Molecular Pathology, Switzerland., Barts Cancer Institute, London, UK., WHO Classification of Tumours Head, Evidence Synthesis and Classification, International Agency for Research on Cancer (IARC), World Health Organization, 150 Cours Albert Thomas, Lyon, France., Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada., Department of Surgical Pathology, Aichi Medical University, Aichi, Japan., Department of Pathology, Medical University of Vienna, General Hospital of Vienna, Wien, Austria., Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Germany., Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA., Department of Biomedical Research (DBMR), Bern Center for Precision Medicine Inselspital University Hospital Bern, Bern, Switzerland., The University of Sydney, Sydney Medical School Sydney, NSW, Australia., The Francis Crick Institute, London and The Royal Marsden NHS Foundation Trust, London, UK., Division of Pathology, Singapore General Hospital, Singapore., Histopathology and Molecular Diagnostics University Hospital Careggi, Florence, Florence, Italy., Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA., The University of Tennessee Health Science Center College of Medicine Memphis, Tennessee, USA.