PMC10410445_01
Ulcerative lesion measuring 20 x 15 x 10 mm located at left root of penis; surrounding penile skin and left hemiscrotum were indurated, inflamed, and haemorrhagic with whitish flaky deposits.
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The surrounding penile skin and left hemiscrotum were indurated, inflamed, and haemorrhagic with whitish flaky deposits ( Figure 1 ).
(A) Histologically, the penile tumour is composed of nests and lobules of malignant cells with clear foamy cytoplasm (H&E, x10). (B) Higher power view of the tumour cells shows enlarged vesicular nuclei, conspicuous nucleoli, and abundant multivesicular cytoplasm (H&E, x40). (C) Pagetoid spread along the dermo-epidermal junction is evident as adjacent to the main tumour mass (H&E, x10), (D) which is highlighted by CK7 immunostain (x4). (E, F) Both the invasive and pagetoid components show positivity to EMA (x4, x10).
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HPE of the excised tumour nodule revealed malignant cells exhibiting sebaceous differentiation characterized by pleomorphic vesicular nuclei with prominent eosinophilic nucleoli, abundant vacuolated cytoplasm, and numerous mitotic figures ( Figures 2A, B ). The malignant cells also showed pagetoid spread along the dermo-epidermal junction and surrounding the hair follicles ( Figure 2C ). IHC studies showed similar EMA and CK7 expression as in the biopsied sample ( Figure 2D ). The tumour showed positivity to EMA and CK7, both in the invasive component and in the pagetoid spread (which is located within the epidermal and dermo-epidermal junction).  Figures 2E, F  show an EMA stain in this tumour.
Post-op image showing split skin graft.
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SSG was completely taken by the host ( Figures 3 ,  4 ) with good penile erection.
Split skin graft was fully taken by host without contracture; penis appeared normal.
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SSG was completely taken by the host ( Figures 3 ,  4 ) with good penile erection.