Magnetic resonance imaging of penile paraffinoma: case report

Abstract

BackgroundPenile paraffinoma is a well-known delayed complication of paraffin oil injection into the penis for penile girth augmentation but its MRI features have not been previously described.Case presentationA 35-year-old Ukraine man presented with erectile dysfunction, voiding difficulty and an irregular, hard and painful penile mass that had progressively grown over the last year. He reported having received, seven years before, several penile injections of paraffin oil for penile girth augmentation. On physical examination, the mass was tender, poorly delimited, and involved the whole penile shaft and the cranial part of the scrotum. Preoperative MRI, performed to determine the extent of tissue to be removed and the possibilities of penile reconstruction, showed a newly-formed homogeneous tissue, compressing but not infiltrating Buck’s fascia, iso-hypointense relative to muscle on T1-weighted sequences, and with a low signal intensity at T2-weighted sequences. On T1-weighted fat suppressed sequences, it did not enhance with contrast administration. MRI data were confirmed by surgical findings, as the newly-formed scar tissue did not infiltrate Buck’s fascia. Pathology confirmed the diagnosis of penile paraffinoma.ConclusionMRI seems to provide an adequate imaging of the histological events occurring after injection of paraffin oil in the subcutaneous tissues. Penile paraffinoma remains a clinical diagnosis, but MRI features may be helpful in planning an adequate surgical strategy and, in selected cases, establishing the differential diagnosis with other penile diseases, including cancer.

Two-Stage Penile Reconstruction after Paraffin Injection: A Case Report and a Systematic Review of the Literature

“…Simple excision of the paraffinoma with primary closure has been described in 6 studies with a total of 42 patients (27.6%) [ 17 , 18 , 19 , 20 , 29 , 34 ]. Twelve patients in 5 studies underwent a split thickness skin graft (STSG) harvested from the upper thigh (7.9%), [ 12 , 18 , 22 , 30 , 35 ].…”

Male esthetic genital surgery: recommendations and gaps to be filled

“…These substances could cause a foreign body reaction leading to penile scarring and deformity, abscess formation, ulceration, and erectile dysfunction [ 103 ]. Although all such problems are well known, self-injections remain a common means of increasing penile girth for Eastern Europe and Eastern Asia people [ 104 ]. Reasons for this unreasonable practice include, on one hand, the fact that it is easily available and easily performed by non-medical personnel or the patient himself, on the other hand, lack of standardized medical or surgical techniques for penile girth enhancement.…”

Filler Reactions: Case Report and Review of the Literature

“…However, most patients do not want surgery due a lack of comesis afterwards. Magnetic resonance imaging (MRI) may be used for exact identification of the surgical site (19,20). Spotty mass appearance (60%), nodules in fat density (100%), nodular (100%) and ring (80%) calcification are detected on tomography (20).…”