Histological anatomical levels of penile shaft. A histochemical evaluation of 15 cases

Abstract

Abstract Introduction/Objective Penile carcinomas (PeCa) arising in the skin of the shaft are rare. Staging systems for PeCa are based on tumor invasion of anatomical levels designed for tumors arising in the glans and foreskin but not for those primary of the shaft. There is scant information about anatomical levels in the shaft. The objective of this study was to evaluate and describe anatomical levels of the shaft with emphasis of the fascias, using histochemical stains. Methods/Case Report Sections of penile mid shaft from 15 penectomies with PeCa from 2000-2015 were evaluated. H&E, trichromic and orcein stains were performed to evaluate and describe anatomical levels of the shaft. Results (if a Case Study enter NA) Skin: Epidermis: 7-15 cell thick, thin keratin, granulosis, basal pigmentation. Papillary dermis: Loose connective tissue, capillaries, nerve fibers pilo-sebaceous structures. Absence of elastic fibers. Reticular dermis. prominent elastic fibers layer parallel to epidermis merging with dartos. Dartos (superficial fascia): Poorly delineated, merging with reticular layer with no separating space, composed of thin smooth muscle bundles. Deep fascia (Busck's fascia): All tissues between dartos and tunica albuginea. Fibro-elastic, encases vessels, nerves and fibro adipose tissues. Closely attached to the albuginea.Tunica albuginea: Dense mostly fibrous tissue with few elastic fibers encasing corpora cavernosa. Corpus cavernosum: Thick-walled inter-anastomosed vessels. Smaller nutritional vessels, nerves and adipose tissue. No elastic fibers present. Conclusion There are 5 distinct anatomical layers in the shaft. Reticular dermis and dartos should be considered as one layer given the poor delineation between them. This knowledge is necessary for staging and prognosis of the rare PeCa arising in the shaft.