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Epithelioid hemangioma of the penis: case report and review of literature.

Ismail M, Damato S, Freeman A, Nigam R - J Med Case Rep (2011)

Bottom Line: Epithelioid hemangioma is a rare vascular tumor found in the penis.It is essential to avoid misdiagnosis with Peyronie's disease and penile cancer, as management differs significantly.Optimal management is complete local excision and periodic physical examination for local recurrence.

View Article: PubMed Central - HTML - PubMed

Affiliation: The Royal Surrey County Hospital, Guildford, Surrey, UK. ms18273@gmail.com.

ABSTRACT

Introduction: Epithelioid hemangioma is a rare vascular tumor found in the penis. It is essential to avoid misdiagnosis with Peyronie's disease and penile cancer, as management differs significantly.

Case presentation: We present a case of epithelioid hemangioma of the penis in a 50-year-old Caucasian man. We also review the literature to evaluate the incidence of benign vascular anomalies of the penis and their management.

Conclusions: Epithelioid hemangioma of the penis should be considered in the differential diagnosis of patients presenting with painful penile lumps. A thorough histological and immunohistochemical examination is required to make the diagnosis. Optimal management is complete local excision and periodic physical examination for local recurrence.

No MeSH data available.


Related in: MedlinePlus

Ultrasound scan image of the penis. (A) Ultrasound picture shows the epithelioid hemangioma lesion on the dorsum of the penis. Inherent vascularity is visible within the lesion in red color. (B) Both corpora cavernosa can be seen.
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Figure 1: Ultrasound scan image of the penis. (A) Ultrasound picture shows the epithelioid hemangioma lesion on the dorsum of the penis. Inherent vascularity is visible within the lesion in red color. (B) Both corpora cavernosa can be seen.

Mentions: A 50-year-old Caucasian man presented to our facility with a painful nodule on the dorsum of his penis, which had developed over the last six months. It became more painful over time and interfered with his sexual activity. Our patient reported no erectile dysfunction or penile deviation. His medical history was unremarkable. A physical examination revealed a 5 mm tender, firm nodule at the mid shaft of the penis dorsally. There was no inguinal lymphadenopathy. A penile ultrasound scan demonstrated a well circumscribed lesion (6 × 8 mm) over the dorsal aspect of the penis within the subcutaneous tissue, superficial to the corpus cavernosum (Figure 1). There was inherent blood flow within the lesion. With suspicion of a penile vascular tumor, we performed a local excision of the lesion under general anesthesia. Intra-operatively, the lesion was intimately involved with the neurovascular bundle. Feeding vessels were identified under magnification and were ligated with preservation of the neurovascular bundles. Histopathological examination revealed a well circumscribed, unencapsulated lesion (Figure 2) composed of central sheets of plump epithelioid cells with scattered vessels at the periphery. The epithelioid cells had abundant eosinophilic cytoplasm with large nuclei and distinct central nucleoli (Figure 3). There was no significant cytological atypia and only a few cells in mitosis. There were scattered capillary vessels lined by epithelioid cells at the periphery of the lesion (Figure 4). Immunohistochemical analysis demonstrated strong expression of CD31 and CD34 and no expression of S100 protein or desmin (Figure 3). A pathological diagnosis of epithelioid hemangioma was made. At three months follow-up our patient reported complete resolution of pain and normal erectile function. A physical examination revealed no local recurrence.


Epithelioid hemangioma of the penis: case report and review of literature.

Ismail M, Damato S, Freeman A, Nigam R - J Med Case Rep (2011)

Ultrasound scan image of the penis. (A) Ultrasound picture shows the epithelioid hemangioma lesion on the dorsum of the penis. Inherent vascularity is visible within the lesion in red color. (B) Both corpora cavernosa can be seen.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3141710&req=5

Figure 1: Ultrasound scan image of the penis. (A) Ultrasound picture shows the epithelioid hemangioma lesion on the dorsum of the penis. Inherent vascularity is visible within the lesion in red color. (B) Both corpora cavernosa can be seen.
Mentions: A 50-year-old Caucasian man presented to our facility with a painful nodule on the dorsum of his penis, which had developed over the last six months. It became more painful over time and interfered with his sexual activity. Our patient reported no erectile dysfunction or penile deviation. His medical history was unremarkable. A physical examination revealed a 5 mm tender, firm nodule at the mid shaft of the penis dorsally. There was no inguinal lymphadenopathy. A penile ultrasound scan demonstrated a well circumscribed lesion (6 × 8 mm) over the dorsal aspect of the penis within the subcutaneous tissue, superficial to the corpus cavernosum (Figure 1). There was inherent blood flow within the lesion. With suspicion of a penile vascular tumor, we performed a local excision of the lesion under general anesthesia. Intra-operatively, the lesion was intimately involved with the neurovascular bundle. Feeding vessels were identified under magnification and were ligated with preservation of the neurovascular bundles. Histopathological examination revealed a well circumscribed, unencapsulated lesion (Figure 2) composed of central sheets of plump epithelioid cells with scattered vessels at the periphery. The epithelioid cells had abundant eosinophilic cytoplasm with large nuclei and distinct central nucleoli (Figure 3). There was no significant cytological atypia and only a few cells in mitosis. There were scattered capillary vessels lined by epithelioid cells at the periphery of the lesion (Figure 4). Immunohistochemical analysis demonstrated strong expression of CD31 and CD34 and no expression of S100 protein or desmin (Figure 3). A pathological diagnosis of epithelioid hemangioma was made. At three months follow-up our patient reported complete resolution of pain and normal erectile function. A physical examination revealed no local recurrence.

Bottom Line: Epithelioid hemangioma is a rare vascular tumor found in the penis.It is essential to avoid misdiagnosis with Peyronie's disease and penile cancer, as management differs significantly.Optimal management is complete local excision and periodic physical examination for local recurrence.

View Article: PubMed Central - HTML - PubMed

Affiliation: The Royal Surrey County Hospital, Guildford, Surrey, UK. ms18273@gmail.com.

ABSTRACT

Introduction: Epithelioid hemangioma is a rare vascular tumor found in the penis. It is essential to avoid misdiagnosis with Peyronie's disease and penile cancer, as management differs significantly.

Case presentation: We present a case of epithelioid hemangioma of the penis in a 50-year-old Caucasian man. We also review the literature to evaluate the incidence of benign vascular anomalies of the penis and their management.

Conclusions: Epithelioid hemangioma of the penis should be considered in the differential diagnosis of patients presenting with painful penile lumps. A thorough histological and immunohistochemical examination is required to make the diagnosis. Optimal management is complete local excision and periodic physical examination for local recurrence.

No MeSH data available.


Related in: MedlinePlus