Skin cancer Quiz: Ace Your Exams

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A 61-year-old man presents to the office for the evaluation of a lesion on the shaft of his penis. The patient first noticed the lesion around 6 months ago and reports that it has gradually increased in size over time. Past medical history is significant for hypertension treated with hydrochlorothiazide. He is sexually active with multiple male and female partners and uses condoms inconsistently. Temperature is 37.0°C (98.6°F), pulse is 84/min, respirations are 14/min, and blood pressure is 136/88 mmHg. Physical examination shows a single, well-defined erythematous velvety plaque on the shaft of the penis. The decision to perform a biopsy of the lesion is made. Histopathology is shown below:

A high magnification image shows a biopsy of squamous cell carcinoma, with invasive nests of atypical squamous cells extending into the underlying dermis. The tumor has a pushing border.

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Which of the following is the most likely diagnosis?

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