%0 Journal Article
%T Continuous Spatial Sequences of Lichen Sclerosus, Penile Intraepithelial Neoplasia, and Invasive Carcinomas: A Study of 109 Cases
%A Adriano Piris
%A Antonio L. Cubilla
%A Cecilia Lezcano
%A Diego F. Sanchez
%A Gustavo Ayala
%A Ingrid Rodriguez
%A Lorena Gonzalez Stark
%A Mai P. Hoang
%A Martin C. Mihm
%A Mar¨ªa Jos¨¦ Fern¨¢ndez-Nestosa
%A Patricia Zarza
%A Sabrina Oneto
%A Sof¨ªa Ca£¿ete-Portillo
%J International Journal of Surgical Pathology
%@ 1940-2465
%D 2019
%R 10.1177/1066896918820960
%X Lichen sclerosus (LSc) with penile cancer is found in about two thirds of specimens. It has been hypothesized that LSc represents a precancerous condition. To qualify as such, in addition to cytological atypia and similarity with the invasive tumor, a spatial correlation between LSc and neoplastic lesions needs to be demonstrated. The purpose of this study was to evaluate such a spatial relationship. Circumcision (28 cases) and penectomy (81 cases) specimens were evaluated. All cases had LSc, penile intraepithelial neoplasia (PeIN), and/or invasive squamous cell carcinomas. We examined LSc in relation to invasive carcinoma, PeIN, and normal epithelia. Invasive squamous cell carcinomas, classified according to the World Health Organization criteria as non¨Chuman papillomavirus (HPV)-related and HPV-related PeIN, were present in 100 cases. Non-HPV-related (differentiated) PeIN was the most common subtype associated with LSc (89%). There were 5 spatial patterns identified: (1) LSc adjacent to PeIN (23%), (2) LSc adjacent and comprising PeIN (42%), (3) LSc next to and within invasive carcinomas (8%), (4) LSc throughout the sequence PeIN-invasive carcinoma (24%), and (5) LSc was separate (with normal tissue between the lesions) from PeIN and/or invasive carcinomas in a minority of cases (3%). LSc within the cancer was not previously described. In this series, we found 35 cases with LSc within invasive carcinomas. The striking continuous spatial relationship among LSc, PeIN, and/or invasive carcinoma as shown in this study may be a necessary (but not sufficient) condition for the hypothesis postulating LSc as a penile precancerous lesion
%K lichen sclerosus
%K penile lesions
%K penile intraepithelial neoplasia
%K invasive penile carcinomas
%K penile cancer
%U https://journals.sagepub.com/doi/full/10.1177/1066896918820960