<prompt> Answer this question truthfullyWhat is the pathophysiology behind penile carcinoma?  <response>: <reason> Penile cancers traditionally begin as small lesions, most commonly on the glans or prepuce About 95 of penile cancers develop from flat, scale-like cells called squamous cells. squamous cell carcinoma SCC can develop anywhere on the penis, but most develop on the foreskin in uncircumcised men or the glans. This type of cancer is typically slow growing. When found early, it is often curable Penile cancer arises from precursor lesions, which generally progress from low-grade to high-grade lesionsGrossly noted growth patterns include:On microscopic histopathological analysis, characteristic findings of carcinoma of the penis include:keratinization intercellular bridges Most histologic subtypes resemble those in vulva, anus or buccal mucosa 48 - 65 are squamous cell carcinoma Verruciform tumors are verrucous, warty, papillary or cuniculatum carcinomas Basaloid and sarcomatoid carcinomas usually have a vertical growth patternPenile malignant lesions and tumors, can be divided into HPV -related and non HPV -related groups For HPV related penile cancers this sequence is as follows: Squamous hyperplasia Low-grade penile intraepithelial neoplasia PIN High-grade PIN carcinoma in situ Bowens disease, erythroplasia of Queyrat and bowenoid papulosis BP Invasive carcinoma of the penisNon- HPV related penile squamous cell cancers include:SCC usual typeNot Otherwise Specified NOS Pseudohyperplastic carcinoma Pseudoglandular carcinoma Verrucous carcinoma Carcinoma cuniculatum Papillary carcinoma NOS Adenosquamous carcinoma Sarcomatoid carcinomaTumors with basal andor warty morphology display HPV more frequentlyGrading:Grade 1: well differentiated cells, almost undistinguishable from normal squamous cells except for the presence of minimal basal parabasal cell atypia Grade 2: all tumors not fitting into criteria for grade 1 or 3 Grade 3: any anaplastic cells 