A 60 years old male presented with complaints of an ulcerated lesion on the glans penis of 3 months duration. Clinical examination revealed a 3 × 2 cm ulcerated tumor involving the dorsal aspect of the glans penis. The penile shaft was not involved by the tumor. The urethral meatus was free. There were insignificant 0.5 cm nodes in both inguinal regions.
Histopathologic examination revealed the tumor to be a sarcomatoid carcinoma. A chest radiograph did not reveal any abnormalities.
The patient underwent a partial amputation and had an uneventful postoperative recovery. He has completed 6 months of follow-up and is doing well.
Multiple sections were taken from the primary tumor for histopathologic examination. Paraffin embedded, hematoxylin, and eosin stained slides were first used to establish the tumor morphology and initial histopathological tumor typing. The microscopic picture showed fascicles and sheets of spindle-shaped cells with moderate eosinophilic cytoplasm, admixed with areas of atypical squamous epithelial cells . Myxoid change and osseous metaplasia were also noted. Immunohistochemistry showed positivity of the epithelial cells for epithelial membrane antigen (EMA) and keratin. The sarcomatous area was diffusely positive for vimentin  and also for keratin. The tumor cells were negative for smooth muscle actin, desmin, and S-100.
Nests and islands of malignant squamous cells admixed with sarcomatous component
Sarcomatous areas showing immunoreactivity to vimentin
A final diagnosis of nonmetastatic sarcomatoid carcinoma (undifferentiated) was made.