penis

what is the coronal sulcus

the area under the foreskin flap

what margins should be inked with a foreskin specimen

mucosal and skin margin

how should you section a foreskin specimen

perpendicular to the resection margin

what two things abt the lesion are important to measure with a foreskin specimen

depth of invasion and distance to closest margin

what should the soft tissue margin for a penectomy include

erectile tissue and urethra

besides soft tissue margin, what is the other penectomy margin

skin

what can be present in the uninvolved penile skin

PeIN

What is PeIN

penile intraepithelial neoplasia

what can PeIN present as

lichen sclerosis or epidermal thickening

what prognostic group is this: verrucous, papillary, warty/condylomatous carcinomas

low risk

what prognostic group is this: basaloid, sarcomatous, adenosquamous, poorly differentiated scc

high risk

high grade variants of warty/condylomatous carcinomas and most SCC of the usual type is what prognostic group

intermediate

this HPV assoc disease affects older men, shaft and scrotum, solitary gray plaque, low risk to SCC

Bowen disease

this HPV assoc disease is younger sexually active men associated with HPV 16 with papillary lesions with no SCC progression

bowenoid polyposis

what tumor suppressor genes are inactivated with HPV proteins E6/7

RB and P53

When measuring DOI/thickness of an SCC tumor, how should you do it?

from epithelial-stomal junction of adjacent nonneoplastic epithelium to the deepest point of invasion

when measuring thickness/DOI of a verruciform tumor, how should you do it

from the surface to the deepest point of invasion

where do the majority of penile SCC originate

glans, foreskin, shaft

where is tumor recurrence less frequent

less frequent in foreskin than glans

what are glans carcinomas associated with

HPV and deeper invasion

what classifies glans tumor as a pt1

invades lamina propria

what classifies foreskin tumor as pt1

invades dermis, lamina propria, or dartos fasica

what classifies shaft tumor as pt1

invades connective tissue between epidermis and corpora

tumor is without lymphovascular invasion or perinueural invasion and is not high grade and does not evade past lamina propria

pT1a

tumor exhibits lymphovascular invasion or perineurial invasion or is high grade but doesn’t extend past lamina propria

pT1b

tumor invades into spongiosum with or without urethral invasion

pT2

tumor invades cavernous with or without urethral invasion

pT3

tumor invades other adjacent structures like scrotum, prostate, pubic bone

pT4

what is the most common site of non-nodal metastasis

liver, heart, lungs

why is it important to indicate that there is a basaloid SCC in a final dx

basaloid is higher risk

what is penectomy cpt

88309

what is newborn circumcision cpt

88302

what is non newborn circumcision cpt

88304

mets to what lymph nodes are common

inguinal lymph nodes