PENIS (ICD‐O‐3 C60)

Rules for Classification

The classification applies only to carcinomas. There should be histological confirmation of the disease.

Anatomical Subsites (Fig. 463)

Prepuce (C60.0)
Glans penis (C60.1)
Body of penis (C60.2)

Regional Lymph Nodes

The regional lymph nodes are the superficial and deep inguinal and the pelvic nodes.

Schematic illustration of Prepuce, Glans penis and Body of penis. — **Fig. 463**

TNM Clinical Classification

T – Primary Tumour

TX	Primary tumour cannot be assessed
T0	No evidence of primary tumour
Tis	Carcinoma in situ (penile intraepithelial neoplasia – PeIN)
Ta	Noninvasive localized squamous cell carcinoma¹ (Fig. 464)
T1	Tumour invades subepithelial connective tissue² (Figs. 465, 466)
	T1a	Tumour invades subepithelial connective tissue without lymphovascular invasion or perineural invasion and is not poorly differentiated
	T1b	Tumour invades subepithelial connective tissue with lymphovascular invasion or perineural invasion or is poorly differentiated
T2	Tumour invades corpus spongiosum with or without invasion of the urethra (Figs. 467, 468)
T3	Tumour invades corpus cavernosum with or without invasion of the urethra (Figs. 467, 468)
T4	Tumour invades other adjacent structures (Figs. 469, 470)

Notes

¹ Including verrucous carcinoma.

²Glans: Tumour invades lamina propria.Foreskin: Tumour invades dermis, lamina propria or dartos fascia.Shaft: Tumour invades connective tissue between epidermis and corpora and regardless of location.

Schematic illustration of Noninvasive localized squamous cell carcinoma. — **Fig. 464**

Schematic illustration of tumour invades subepithelial connective tissue. — **Fig. 465**

Schematic illustration of tumour invades subepithelial connective tissue with lymphovascular invasion or perineural invasion or is poorly differentiated. — **Fig. 466**

Schematic illustration of tumour invades corpus spongiosum with or without invasion of the urethra. — **Fig. 467**

Schematic illustration of tumour invades other adjacent structures. — **Fig. 469**

N – Regional Lymph Nodes

NX	Regional lymph nodes cannot be assessed
N0	No palpable or visibly enlarged inguinal lymph nodes
N1	Palpable mobile unilateral inguinal lymph node (Fig. 471)
N2	Palpable mobile multiple (Fig. 472) or bilateral inguinal lymph nodes (Fig. 473)
N3	Fixed inguinal nodal mass (Fig. 474) or pelvic lymphadenopathy unilateral (Fig. 475) or bilateral (Fig. 476)

Schematic illustration of Palpable mobile unilateral inguinal lymph node. — **Fig. 471**

Schematic illustration of Palpable mobile multiple. — **Fig. 472**

Schematic illustration of bilateral inguinal lymph nodes. — **Fig. 473**

Schematic illustration of Fixed inguinal nodal mass. — **Fig. 474**

Schematic illustration of pelvic lymphadenopathy unilateral. — **Fig. 475**

Schematic illustration of bilateral. — **Fig. 476**

M – Distant Metastasis

M0	No distant metastasis
M1	Distant metastasis

pTNM Pathological Classification

The pT categories correspond to the T categories. The pN categories are based upon biopsy, or surgical excision.

pNX	Regional lymph nodes cannot be assessed
pN0	No regional lymph node metastasis
pN1	Metastasis in one or two inguinal lymph nodes
pN2	Metastasis in more than two unilateral or bilateral inguinal lymph nodes
pN3	Metastasis in pelvic lymph node(s), unilateral or bilateral or extranodal extension of regional lymph node metastasis
pM1	Distant metastasis microscopically confirmed