Diagnosis: Basaloid carcinoma of the penis.

Comment: This is an aggressive, HPV-related, often deeply invading penile neoplasm composed of small or intermediate-sized basophilic cells with numerous mitoses. The typical pathologic presentation is centrally necrotic (comedocarcinoma-like) solid nests of small, poorly differentiated cells with scant cytoplasm resembling basal cell carcinoma, except that peripheral palisading is not conspicuous (Cubilla AL et al. Basaloid squamous cell carcinoma: a distinctive human papilloma virus-related penile neoplasm: a report of 20 cases. Am J Surg Pathol 1998;22:755-61).