Syringocystadenocarcinoma Papilliferum In Situ of the Penis Associated with Oncogenic HPV Infection.
Shachar Sade, Mathew A Plant, Ayman Al Habeeb, Danny Ghazarian. Sunnybrook Health Sciences Center, Toronto, ON, Canada; University of Toronto, ON, Canada; University Health Network, Toronto, ON, Canada
Background: Syringocystadenocarcinoma papilliferum (SCACP) is the malignant version of syringocystadenoma papilliferum (SCAP), which is a benign tumor of either eccrine, apocrine or apoeccrine origin that typically occurs on the scalp or face. SCACP is a rare phenomenon with only 10 cases reported, the vast majority arising from longstanding SCAP lesions. SCACP in situ (SCACP-IS) is an even rarer phenomenon with only 4 cases having been described. None of these have been reported in the genitalia (although one case occurred in perianal skin), and there has been no reported association with HPV infection.
Design: Histological examination, immunohistochemical characterization, and molecular HPV subtyping were performed on a routinely processed excisional biopsy. A clinical review was also performed.
Results: Histomorphology showed classic features for syringocystadenocarcinoma papilliferum which were confined to the surface epithelium with no evident breach of the basement membrane consistent with in situ disease. The lesion demonstrated malignant cytomorphology and there was no background evidence of a precursor lesion. Immunohistochemical analysis was also consistent with positive staining for Cam5.2, CK7, CEA and EMA. CK5/6, GCDFP, ER, AR and p63 were negative within lesional cells, however, p63 did highlight a preserved basal cell layer. Linear array analysis revealed the presence of HPV subtype 68.
Conclusions: We present a case of SCACP-IS which occurred spontaneously on the penis of an 83 year old man. This represents the first described case of in-situ SCACP occurring on the penis as well as the first reported case of SCACP of any kind to test positive for oncogenic HPV DNA.
Wednesday, March 2, 2011 1:00 PM
Poster Session VI # 117, Wednesday Afternoon