Original ArticlesWarty (Condylomatous) Squamous Cell Carcinoma of the Penis A Report of 11 Cases and Proposed Classification of `Verruciform' Penile TumorsCubilla, Antonio L. M.D.; Velazques, Elsa F. M.D.; Reuter, Victor E. M.D.; Oliva, Esther M.D.; Mihm, Martin C. Jr. M.D.; Young, Robert H. M.D.Author Information From Instituto de Patologia e Investigacion and Facultad de Ciencias Medicas, Asuncion, Paraguay (A.L.C.); Department of Pathology, New York University, New York, New York, U.S.A. (E.F.V); Department of Pathology, Memorial Sloan-Kettering Cancer Center, Cornell University Medical College, New York, New York, U.S.A. (V.E.R); James Homer Wright Pathology Laboratories, Massachusetts General Hospital and Department of Pathology, Harvard Medical School, Boston, Massachusetts, U.S.A. (E.O., M.C.M., R.H.Y.). Part of this study was funded by “Funduna” and “Dipri” of the Universidad de Asuncion, Paraguay. Address correspondence and reprint requests to Robert H. Young, MD, Massachusetts General Hospital, Department of Pathology, Boston, MA 02114, U.S.A. The American Journal of Surgical Pathology: April 2000 - Volume 24 - Issue 4 - p 505-512 Buy Abstract Within the spectrum of penile squamous cell carcinomas, those that we descriptively refer to collectively as the “verruciform” lesions are particularly difficult to subclassify. In a review of 50 such tumors, we found 11 distinctive neoplasms with condylomatous features conforming to the appearance of so-called “warty (condylomatous) carcinoma.” The average patient age was 55 years and the average duration of disease was 19 months. The primary tumor involved multiple anatomic sites (glans, coronal sulcus, and foreskin) in seven cases and a single site (glans or foreskin) in four cases. Grossly, white to gray cauliflower-like tumors typically measuring approximately 5 cm were noted. Histologically the tumors were mainly papillomatous with acanthosis and hyperkeratosis. The papillae had prominent fibrovascular cores. The most conspicuous microscopic findings were striking nuclear atypia of koilocytotic type and clear cytoplasm. The interface between tumor and stroma was irregular in the majority of cases; deep invasion of corpus cavernosum was noted in five cases. The differential diagnosis included verrucous carcinoma, low-grade papillary squamous cell carcinoma, not otherwise specified, and giant condyloma acuminatum. Among other differences, the first two lesions show no koilocytotic changes and the last lacks malignant features and irregular stromal invasion. Metastatic spread occurred in two patients; both are alive with evidence of recurrent disease 12 and 72 months after initial diagnosis. A third patient was alive with recurrent disease 12 months after diagnosis. Five patients were free of disease 8, 12, 24, 52, and 108 months after diagnosis. Three patients were lost to follow up. Warty (condylomatous) carcinomas of the penis are morphologically distinctive verruciform neoplasms with features of human papillomavirus-related lesions and should be distinguished from other verruciform tumors so that differences in behavior, if any, between these tumors will become established. © 2000 Lippincott Williams & Wilkins, Inc.