Epidermal inclusion cyst of the penis after urethroplasty causing an urethro-cutaneous fistula: a first case report

A case report of an epidermoid inclusion cyst following repair of hypospadias

INTRODUCTION AND IMPORTANCE

Epidermoid cysts also known as epidermal inclusion cysts are the most common type of cutaneous cysts. These are derived from ectoderm with a lining of stratified squamous epithelium. Penile epidermoid cysts however are very rare. We report a case of Fifteen years old male with complain of slow growing mass at ventral aspect of shaft of penis along with urethrocutaneous fistula following hypospadias surgery. Surgical excision was done of the cyst. Histopathology of the sample revealed an epidermoid cyst.

CASE PRESENTATION

We report a case of a Fifteen years boy who underwent midshaft hypospadias repair at the age of five years. During postoperative period stent was removed and one week after that he developed a urethrocutaneous fisula. At seven years of age patient reported a small swelling on the penile shaft which gradually increased in size over the years, however, he seeks no medical care for it.

CLINICAL DISCUSSION

At time of presentation swelling was separately appreciable from urehtrocuataneous fistula and extending from subcoroanal to midshaft of penis. We did excision of epidermal cyst and repair of urethrocutaneous fistula.

CONCLUSIONS

Epidermal inclusion cyst as a complication of hypospadias surgery is a very rare situation. The diagnosis is made histologically and surgical excision is sufficient for treatment.

Acquired Penile Epidermoid Cysts in Children

Background

In this study, we aim to present the experience of a tertiary center regarding penile epidermoid cysts over 15 years.

Methodology

Patient files of those who underwent surgical excision for penile epidermoid cysts between 2005 and 2019 were reviewed retrospectively. The demographics, clinical characteristics, etiological factors, cyst features, surgical techniques, complications, and follow-up data were analyzed.

Results

In total, 24 penile epidermoid cysts were excised in 21 boys. The median age at the time of surgery was 52 (15-204) months. The median duration between previous surgery and cyst excision was 40 (1-180) months. In total, 11 cases had a history of circumcision, and 10 had undergone hypospadias surgery. There was no significant difference between these two etiologic groups (p > 0.05). The main symptom was an asymptomatic penile mass. The average cyst size was 9.4 ± 6.7 mm. All cysts were completely excised with incisions made over old scars, except one. No complications were observed during a median follow-up period of 50 (12-120) months, and only one recurrence was noted.

Conclusions

Acquired penile epidermoid cysts may present as an early or late complication after penile surgery. Complete excision with an incision along the existing scars seems to be an effective solution for preventing new scars.