Epithelioid sarcoma of the penis—a rare differential diagnosis of Peyronie's disease

Abstract

We report on a case of penile epithelioid sarcoma in a 29-year-old man presenting with a dorsal penile plaque that primarily was misdiagnosed as Peyronie's disease. Although the initial clinical findings of these two different entities appear similar, the consequence for the patient is severe. The only way of differentiating these disorders are histological findings. The principal microscopic characteristics of epithelioid sarcoma are the distinctive nodular arrangement, central degeneration and necrosis of the tumor cells with epithelioid appearance and eosinophilia. Immunohistochemical data (cytokeratin, epithelial membrane antigen, vimentin, CD 34, desmin) confirm the diagnosis. We conclude that in cases with slightest doubts on the diagnosis of Peyronie's disease, especially in younger men suffering from a fast-growing penile induration, a bioptic clarification of the entity should be performed to exclude a high malignant disease that can be only treated as far as it is localized by radical surgery.

Complete resection of penile schwannoma without sexual dysfunction

“…[1,8] The clinical and radiographic findings of penile schwannoma are non-specific and the lesion may be misdiagnosed as Peyronie's disease plaques, fibroma, lipoma, leiomyoma, fibrosis because of intracavernosal injections for erectile dysfunction, xanthogranulomatous infection, angiomatous tumors, and other malignant tumors such as epithelioid sarcoma, leiomyosarcoma, carcinoma of the urethra, and metastatic penile tumours. [1,[8][9][10][11][12][13] The most common sign of the penile schwannoma at presentation was a solitary, painless and firm penile mass. On the previous reports, they do not cause sexual dysfunction.…”

“…The most advisable treatment for penile schwannomas is surgical approach with complete excision of the mass. [2,5,9] Penile amputation is occasionally required. Although the tumor arised from the left dorsal penile nerve was removed in our case, sensory loss on the penile skin and glans did not developed.…”

Granuloma Annulare of the Penis: A Uncommon Location for an Usual Disease

“…An interrogation of the patient is enough to confirm the diagnosis. 18,19 In difficult cases, immunostaining for cytokeratins confirms the diagnosis of epithelioid sarcoma. 13 Lesions tend to be few in number and may be the only manifestation of the disease.…”

Malignant Tumors of the Penis

“…139,141 For small lesions, surgical excision is generally recommended, and local recurrence is rare if the primary tumor is adequately removed. 142 Other sarcomas of the penis are rare, but there have been reported cases of angiosarcomas, 144,145 epithelioid hemangioendotheliomas, 146,147 epithelioid sarcomas, 148,149 leiomyosarcomas, 150 undifferentiated pleomorphic sarcomas, 151,152 malignant schwannomas, 153,154 rhabdomyosarcomas, [155][156][157][158] and fibrosarcomas. [159][160][161]…”

“…Other sarcomas of the penis are rare, but there have been reported cases of angiosarcomas, epithelioid hemangioendotheliomas, epithelioid sarcomas, leiomyosarcomas, undifferentiated pleomorphic sarcomas, malignant schwannomas, rhabdomyosarcomas, and fibrosarcomas …”