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Local recurrence sites were corpus cavernosum, Buck\u2019s fascia and urethra, regional skin, and prostate. Metastatic sites were lymph nodes (9 cases), liver (7 cases), lungs (6 cases), heart (5 cases), adrenals, bone and skin (3 cases each), thyroid and brain (2 cases each), and pancreas, spleen, and pleura (1 case each). Patients with heart metastasis had arrhythmias. Patients who died and who did not die from penile cancer had different profiles: low-grade superficial tumors with usual and warty subtypes versus high-grade deeply invasive basaloid or hybrid verrucous\/sarcomatoid carcinomas. A natural history model for penile cancer routes of spread is proposed: local intrapeneal, regional and systemic nodes, regional skin, liver, lungs, heart, and other multiple sites.<\/jats:p>","DOI":"10.1177\/1066896909333781","type":"journal-article","created":{"date-parts":[[2009,5,1]],"date-time":"2009-05-01T20:13:33Z","timestamp":1241208813000},"page":"164-169","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Autopsy Findings in 14 Patients With Penile Squamous Cell Carcinoma"],"prefix":"10.1177","volume":"19","author":[{"given":"Alcides","family":"Chaux","sequence":"first","affiliation":[{"name":"Instituto de Patolog\u00eda e Investigaci\u00f3n and Facultad de Ciencias M\u00e9dicas, Universidad Nacional de Asunci\u00f3n, Paraguay"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Reuter","sequence":"additional","affiliation":[{"name":"Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia","family":"Lezcano","sequence":"additional","affiliation":[{"name":"Instituto de Patolog\u00eda e Investigaci\u00f3n and Facultad de Ciencias M\u00e9dicas, Universidad Nacional de Asunci\u00f3n, Paraguay"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elsa","family":"Velazquez","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo","family":"Codas","sequence":"additional","affiliation":[{"name":"Instituto de Patolog\u00eda e Investigaci\u00f3n and Facultad de Ciencias M\u00e9dicas, Universidad Nacional de Asunci\u00f3n, Paraguay"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio L.","family":"Cubilla","sequence":"additional","affiliation":[{"name":"Instituto de Patolog\u00eda e Investigaci\u00f3n and Facultad de Ciencias M\u00e9dicas, Universidad Nacional de Asunci\u00f3n, Paraguay,"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2009,5,1]]},"reference":[{"key":"atypb1","unstructured":"Curado M, Edwards B, Shin H, et al., eds. 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