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Metachronous nodal metastases from HPV-associated penile carcinoma in situ

  • 0Department of Urology, George Washington University School of Medicine, Washington, DC, USA.
Urology Case Reports +

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September 22, 2025

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September 22, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Penile intraepithelial neoplasia (PeIN), a precursor to squamous cell carcinoma, can paradoxically metastasize to lymph nodes. Molecular profiling of this rare event in a basaloid PeIN case revealed key genetic alterations.

Area Of Science

  • Oncology
  • Genitourinary Pathology
  • Molecular Oncology

Background

  • Penile intraepithelial neoplasia (PeIN) is a premalignant lesion of squamous cell carcinoma (SCC) with a 5-15% progression risk.
  • Nodal metastasis from PeIN without evidence of invasive carcinoma is exceptionally rare.

Purpose Of The Study

  • To report a rare case of nodal metastasis from HPV-positive basaloid PeIN.
  • To investigate the genomic alterations associated with this aggressive presentation.

Main Methods

  • Case presentation of a 40-year-old male with recurrent basaloid PeIN.
  • Serial surgical resections and histopathological analysis.
  • Comprehensive genomic profiling of the tumor tissue.

Main Results

  • The patient developed inguinal and pelvic nodal metastases despite all resections showing only carcinoma in situ.
  • Genomic analysis identified EGFR and JUN amplifications and NCOR1 and PRKAR1A losses.
  • These alterations are associated with aggressive tumor biology.

Conclusions

  • This case demonstrates the paradoxical metastatic potential of high-grade PeIN.
  • Molecular profiling can identify aggressive PeIN subtypes.
  • Risk stratification using molecular markers is crucial for managing PeIN.