BACKGROUND: Carcinosarcoma of the penis is extremely rare and little is known about its biological behaviour. AIMS: We report the second such case and discuss its histological categorisation and biological behaviour. METHODS: A total penectomy with perineal urethrostomy was performed without lymphadenectomy in an 83-year old presenting with a fungating penile mass. RESULTS: Microscopy of the gross specimen showed a biphasic tumour with both squamous and spindle cell elements. Immunohistochemical staining for epithelial markers showed positivity in the squamous cell elements but was uniformly negative in the spindle component. Immunohistochemistry of the spindle cell element demonstrated mesenchymal markers. The patient refused further treatment and follow up but presented at 26 months with inguinal lymphadenopathy. Biopsy confirmed squamous cell carcinoma metastasis consistent with penile origin. The patient refused further surgery and received pelvic irradiation. He died 6 months later. CONCLUSIONS: This case illustrates the biological behaviour of this rare tumour.
BACKGROUND:Carcinosarcoma of the penis is extremely rare and little is known about its biological behaviour. AIMS: We report the second such case and discuss its histological categorisation and biological behaviour. METHODS: A total penectomy with perineal urethrostomy was performed without lymphadenectomy in an 83-year old presenting with a fungating penile mass. RESULTS: Microscopy of the gross specimen showed a biphasic tumour with both squamous and spindle cell elements. Immunohistochemical staining for epithelial markers showed positivity in the squamous cell elements but was uniformly negative in the spindle component. Immunohistochemistry of the spindle cell element demonstrated mesenchymal markers. The patient refused further treatment and follow up but presented at 26 months with inguinal lymphadenopathy. Biopsy confirmed squamous cell carcinoma metastasis consistent with penile origin. The patient refused further surgery and received pelvic irradiation. He died 6 months later. CONCLUSIONS: This case illustrates the biological behaviour of this rare tumour.