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A: Gross image of the ulcer post partial penectomy, B. Post partial penectomy of the ulcer.
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In the Operating theatre, he underwent partial penectomy because of extensive involvement and destruction of the urethra (Fig. 1).
(A) (H&E stain). Microscopic image of the tumor's hemorrhagic ulcer site (arrow). The ulcer is characterized by a discontinuation of the epidermal surface by the underlying vascular tumor, (B) The tumor is characterized by an extensive dermal proliferation by atypical vascular channels of mostly spindle cells with nuclear irregularities in a slit-like pattern (arrow) along with extravasated red blood cells.
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Histopathological examination of the lesion showed extensive dermal proliferation by atypical vascular channels of mostly spindle cells with nuclear irregularities in a slit-like pattern (Fig. 2).
(A) The tumor's vascular differentiation was further confirmed with the CD31 immunostain. (B) The tumor's positivity for the HHV-8 immunostaining with a nuclear "dot-like" pattern is essentially consistent with the diagnosis of Kaposi sarcoma.
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Also, immunohistological staining showed a positive reaction for HHV8, CD31 and CD34 which confirm the diagnosis of KS (Fig. 3).
The metastatic tumor's positivity for the HHV-8 immunostaining with the nuclear "dot-like" pattern is consistent with the diagnosis of metastatic Kaposi sarcoma to the lung.
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CT scan which was concerning. CT-guided core biopsy of the lung mass showed metastatic focally necrotic KS with HHV-8 immunostain positive in 70-80% of the tumor cells (Fig. 4).