Primary cavernous hemangioma of the glans penis: rare case report with a review of the literature

Penile vascular anomalies: A retrospective single center study and cumulative analysis of studies from China

Objective

Penile vascular anomalies (PVAs) or hemangioma can arouse patient concern about aesthetics and cause symptoms like bleeding and sexual dysfunction. However, its low incidence and the deficiency of large-volume studies hinder urologists from making informed decisions. This study aimed to investigate the clinical features and treatment experience of PVAs at the Seventh Medical Center of PLA General Hospital, Beijing, China. Furthermore, by systematically analysis of studies on PVAs in Chinese people, we aimed to provide novel insights on the management of this condition.

Methods

We retrospectively investigated clinical features and pathology of surgery-treated PVAs at our center. Moreover, by systemically reviewing the literature from PubMed and the three largest medical databases (China National Knowledge Infrastructure, Wan Fang, and Chinese Medical Journal Database) in China, we analyzed the clinical features and various therapies of PVAs in Chinese people.

Results

Between March 1, 2018 and March 1, 2023, a total of 356 cases with vascular anomalies were treated with surgery at out center. Only seven (2.0%) cases had lesions involving the perineum and external genitalia. All the seven cases were pathologically benign and demonstrated no recurrence over a follow-up period of 1-52 months (median 14 months). A total of 410 cases from 44 studies were selected in the cumulative analysis. Most patients (92.4%) diagnosed with PVAs were asymptomatic, and 68.8% of the patients were treated with sclerotherapy. As to the pathology, 57.1% were venous malformation.

Conclusion

The most common PVA is venous malformation and the majority of patients are asymptomatic. Sclerotherapy and laser have emerged as viable options for treating small lesions. Surgery still has its role in treating large lesions and obtaining pathology. Although PVAs often relapse or demand multiple treatments, the prognosis is favorable.

Incidentally detected cavernous hemangioma of the glans penis after circumcision: A case report

RATIONALE

Hemangiomas of the glans penis are very rare. Treatment options include surgical excision, laser therapy, intralesional sclerotherapy, electrofulguration, and cryotherapy. However, there have been no definitive treatment guidelines established to date.

PATIENT CONCERNS

A 19-year-old man presented with a mass on the glans penis, incidentally found during a circumcision performed at a local urology clinic 3 months before visiting our department.

DIAGNOSES

Histopathological examination identified the specimen as a cavernous hemangioma.

INTERVENTIONS

The mass was completely excised and the resulting wound was closed layer by layer.

OUTCOMES

The patient was discharged without complications, such as wound dehiscence or infection. Follow-up 14 months after surgery showed that the wound was well healed without recurrence and the patient was satisfied with the aesthetic result.

LESSONS

Although there are many options to treat hemangiomas occurring on the glans penis, surgical excision can be considered when they are small in size.

Intralesional injection of triamcinolone acetonide for cavernous hemangiomas: A case report

RATIONALE

Cavernous hemangiomas referred to as venous malformations (VMs), are not true vascular tumors. The treatment of cavernous hemangiomas is controversial.

PATIENT CONCERNS

A five-year-old girl with a cavernous hemangioma on her right buttock had undergone surgery but recurred 1 month after the operation.

DIAGNOSES

Cavernous hemangioma was diagnosed on the basis of physical examination, magnetic resonance imaging (MRI) and postoperative pathologic examination.

INTERVENTIONS

We treated her with intralesional injection of triamcinolone acetonide (TCA) for 8 times.

OUTCOMES

She was cured and had no recurrence during the 3-month follow-up.

LESSONS

This prompts that TCA may provide a more effective and safer choice for the treatment of cavernous hemangiomas.

A creative therapy in treating cavernous hemangioma of penis with copper wire

INTRODUCTION

Cavernous hemangiomas of penis are rare benign lesions infrequently described in the literature. No completely satisfactory treatment has been found to correct the cosmetic deformities especially the extensive hemangiomas of corpus penis.

AIM

In light of the promising application of copper wire/needle in vascular malformations, we began a clinical study to investigate the safety, feasibility, and cosmetic effect of copper wire therapy in treating cavernous hemangioma of penis.

METHODS

Seven patients ranging in age from 12 to 32 years with penile cavernous hemangiomas entered our study from 2005 to 2011. All patients received treatments with percutaneous copper wires.

MAIN OUTCOME MEASURES

Perioperative data including mean operation time, estimated blood loss, length of copper wire retention, and length of hospital stay were analyzed. All possible complications were noted, and cosmetic result was evaluated. Patients were followed up after discharge from the hospital.

RESULTS

All operations were successful, and no obvious complications were observed. The patients were satisfied with the aesthetic results. Follow-up time ranged from 1 to 5 years. Recurrence was discovered in a patient with the largest lesion of corpus penis 2 months after the treatment. Secondary procedure was carried out with the same technique, and no lesions were found later.

CONCLUSIONS

The shortage of studies on this topic prevented us from defining a therapeutic reference standard. The results of our study confirmed that copper wire therapy was a simple, safe, and useful option for penile cavernous hemangioma.

Benign Diseases and Neoplasms of the Penis

This article provides comprehensive review of benign diseases and neoplastic conditions of the penis. It describes and provides representative images of clinical, key pathologic features and ancillary techniques to aid in differential diagnoses. It examines these diseases from the epidemiologic standpoint, looks at environmental and genetic factors, and outlines the new histologic entities for penile neoplasms with distinct outcomes and clinical behavior that have been proposed in recent years.