Penis: Mucoepidermoid Carcinoma andAdenosquamous Carcinoma

Bo$ cdrbrn.d r,o dillitrcl celtutrr ucin-produ.ins ..n5, Tr,. fi ni.Ne e6,3.r-r$Fotrt Ttui nde * h

n pmdkinsatkw houldi!.nr gbntukrstu.toE,drcdejcmreda-bu,o+pid.moidcarciDom .rh kd b"$ "q*--, *d;"".

D!|ewid'pe''ncuh.,hisblogls|'prc*dbbe€rcnon! mriniy mrotbkd by ndisudsquaDNs pri rd rod srrndtuf dm.EDria on. rnc dands

d $c foput.rioB or.€Is, nm.ty sqtr,nous.€th w h ion fthno!, i, lnd hsdy inrgrmediale cltrs b.srbg dlal dir.mli'{on.

Thes unuMl cdrcinomff or ghE p.nt rF dkcnety Es condi.io$ or unkno*n

T$o Unusual Primary Carcinomas of lhe Glans

Na.€e Warnnissorn, B.Sc., MT, MJ.*Pisal Parichatikanond, M,D.*Samr€rng Ratanarapee, M.D.*Chaiyong Nualyong, M.D.+*Ame-on Am€sonbun, B.Sc.*

'I$o c6s of rrE hjsblosic strbIypls or.eribonrs iovohins strB lenk 'E nporred.

{!L?d rhseedsnni mw@pdemoid erc rcma msni admosl6mN erc rcma

llt T?,ndrr ,r!. n.!.., llnr nriii6nr!; {!". dnt! i'!ri n!.,,lrsri maor; {r - !o!nr In!.xur! 2r.!'', 1 ai, 1, a 16in d 1.' h 1 nir 1 nd s a1 a q{. A M !"r!h1a h f V}nrw 1L 1 ̂. !eL'. 1 id,Ahd. nry,w"r1v, 1a7oa

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rD.pa4nqt af Pakotast $D.Ntut ot s,4.ry Fudtt ot Mahine snidj A6pttat. Matiaor urtuisit .

rrtin!$t1U

r!!1!1" '!!:,hfr oais penis i1!.! 2 t1d ii6 mucoepidermod

! ' i , . r n$ : i i ' dd " 60 E -o -5cd . no - " 1 ! { n i co ,q r r ! i q . ' ; , ! o ,

mmnr,fi Li"mr{mi.r*o*u",in!rii iimn!diunriininMl,ii cqua.Nsd i4ed d oi) n!n'!mrhi.r.i d'!!ndln (muc n ptudlct on) nrl!6n8tu:nsriu!ft m:n1lihr

irA'ird"un'lJnhi?!1oi'iNn'! nratAdo! mucicamne 1uLth6lah m:rtm,rr{Niultuivm

ii{rnd!:6!in6 carcirc ".b'y"nic aniisen llLillrn dnldwntinrndtiri'sriT m:nsdfiMi

ndirisv*ifi !6norulinonrlli!1ft lo"i!d!n'n$@ sqlamNs dine

!:LsiiniMlirrMiiludl vqllnl1lo sqFmNs cer tuxtuvfr mm!q$tL5!in'

mrcoepidomod crc noma !6!! 1 a i'io! 6 r! (ti,!{i'u ,

ioir r.n..u ;riirld'"u'",tolnrnrnluinftofi i$imminri. m:.nn'1id!d1'n6xoi

BACKGROUNDTho in.idence or mnligianr ieopbsms oi

r|t penis Bappdirably I in 100,000 or lss ihai054 orallmrl..eophsmsinwc.Mconties ln

2 r!i, ot malc ieoplasmsrAFIP had proposDd

cminona. basl .ell ca'dndm, Pagefs diseae and

d , ] i ' l b y Y I s * a g e m d € d o n l . l b y M a s q aer al' and $c 16r by Jamicsoi' A sinslc.*c ot

Layncfi sd Lu! w4 cbimed ro d$fvc scpddeenlilyeco'ding'odifi.leithislolqidfcalugand

MdTERIALS AND METHODSPrinar cNinon6 or rhc pcik, limired to

pDtrcdory spsimen!, on filcii$eDepmc orFlrholocy or sirnrj H$pi'.r dudis 'he p€riodbcrwcen lc93 and 2003 ser. hisrologicallyrview.d. or rhe 46 ca!$. lvo em sleccd lor dre

fodalinJircd ptriflr blGks$iicd $i$ nudcaminc aod innuiobkro.hcmi.sl srining usitrg rhe ayidi!-bioni-peridae compler (ABc) m.lhod. Posinve shinins rh nEic!.min. atrd nonoclod,l sitl cE"A aDtib.dy r orcdgrdduh dficodion. Ii addition, rhe tisue frc4cnse I w6 $bhind for hNmBron el.ctor ni

insfollow'up,we€obhined fbn ncdi.rlncods

phim$is p(snrcd vnn a ysr long rhrtiic trlcd otrlc s!,is pctris cirumcision ea3 doiD 6 nodhsbcloc pr.strbiion Tte pa&ologic tindings of pre-

glais petu. including thc primrltral ae Th.ly'nph nodessubmnred msaucd 2.m3ttncircra!

dotrs isl.ids (FisuE r)noph ic,clsrroba\ophilic g6iulr.ytoplasmvirha sharp cyrdpl,snh border (Fisur 2) Ther las no

hypdhro'mtin The mnoric counr w$ r5/r0 hpt

(FiBrc 3).'rhe mucji producing ccr! wctu..h.

ru or tumoN. No vascul{ invsioi ws obsered,

ided,ried rhr.e populdidnr of.ells, nrmelysquamousdclh wnh'onorilrmd(Figurca). nucinproducirs cclls wirh niffovilli (Figurc 5), andiftmeliab @lh b.tuing dud differ0nd'on (Figurc6). Ite intmldi,rc ccLls .oihined boln ronofih

The pdied,ppdmcd well durjis lris rhre

itrguma|lynphmdesvffim'pdp.bleT'vorm

slarduhrdirrerentdon Gn &a or onc o! r{o l,y-s6 oflubojdll.clls alisicd *irh rhc lumci or rBnsdi!cribrifodp sn) (Fistrr ? ).

'Il 'e rnaii-in8 9596 df rhc tumor rss vs.orp.sd ot wclldifccntin.d squmous.elL .ninom, (Fieft 3)

cellularly aid intr.lunimlly (Fieure eA). -rhe

ndked 'hese cells (FiguE eB). Brlateml sen'inel

DTSCUSSTON

exhibn.d bod, squmous pd and mucitr prodEins

1r Ndiru

t\

..irS.SfiI*.- -\* il"rrl-:::i:--xr . -l-.- *1.' r','ll$'::,.-.:-...i \ *':::. .-^ ̂

nds.cll .archoma (irow) giridurlly

producinscdrs (!mv hmd) H&E r?0o

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$hirirg numms rorofihmcnr (T) aidd$ooroFu Gcdrqrld) r?,70o

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F?!Et Th. mucin producinsnimvilli (@cisrd). 3howiig !i iih.dhe cE which con-

bii! borh roiofilrncn( fD and microvilli(ncbiglcd). i6,r6o

,''3!'&LightmicrcsmpicpjduE'mcs.,dis'Fisrz Z DisEre slads lined by bll columd.ell!with defitrire lunen fomnion H&Ei200

1u,!{i]lU

FiBd€ L A: In. sbndule ells {debyotricAnris.n a ibody ( sbr) ;20o

mns,ramclylqumous..lh,rtrciipsduciic.ellsand in6odi,t clls coitlmed by ulhhcrurulidodj6.!don, firlfill rh. defidtiotr or ftn tunor rype

1945, consisb ol a varhhle combinlrioo or nu.os

bonchialslands,lqrx,brar,p, nls hcpdobirrq hd, dryfrs, rhymid, mijumivr hd eNnTneaNtn@elidcmoidc&.inomotrhape swith

behavior *i|n esly lymph nodc mddusis (rablcD.

cEre sladuk fomrtid!. rhc rcioist lynph mdes

cminoma. AKqding r. d'c hisrolocic desiiprion.

posd of domirrnr squmo$panwirh focat gtmdu

,dciosqu,fiotrs .flinonr hav. beei rcpoicd(Tabre r ). Th. squmour con pone tu usu.lly show

discEG, vnh *epnmdry tuc rdnnoc pH{rFrelsdsredur poniotr mnmmly ersb junhdov rhc rluamou epirheriun r rhe peinEG.

(usutrr lypo). r[c crsids !rc lilcd by cuboidar or

]r'e oisin or ri.$ rrh.produdns calts

rory .sp,.iry *dr r ) thc cnhryoroghaly frnph(d

r rwo mEcpidchoid .miiona dd s adcndqudos cnhc

. l

6pc.i,ily in fic p. med rcgion(rsiic,sl).2)clusive pluipobr nem or rcasv':d cell like thd insltrJr gland. md 3) 'hc ,berarce or mdicn,itsqumous.ells (as lor c,ie 2, where malisiant sla0dulrcdls we 5ituded svry iiom psim.Ml dei)'

syiorymoudy ii olgiB sulh s rhe lutrg. rhc p,n'

4cubIhAL'A!gl'MT.B'frtdJE'&nudJc.Nd

r c r u d G . F ! i L o i @ 4 . r t r s P r r r e t 5 6

lidibd imbd or cda and rhc rhd dndiotr otfol|owup'orbo$ldcicquamonsondmucocpjd.r.moid cmiiomaorpciis, we pFlq bceg@z sdeptddlyindddbsignjfyu'efioe,ggEsNebchsvior ollne larer en!(y. How.E( addirioml cespi$ qmlihrive and quaitibtive hisrologic pmm.ere6 3d lotrsr.m cliii*l outome m r4uiR! ro

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