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Qi X, Tan Y, Feng Y, Ma D, Wang L, Pang H. Case report and literature review: plexiform schwannoma in the penile and inguinal region in a child. Front Oncol 2024; 14:1356000. [PMID: 38496758 PMCID: PMC10940339 DOI: 10.3389/fonc.2024.1356000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 01/30/2024] [Indexed: 03/19/2024] Open
Abstract
Penile schwannoma is an uncommonly seen peripheral nerve tumor, of which penile plexiform schwannomas (PS) is extremely rare that has only been reported in several adults. We present a case of penile PS with a similar lesion in inguinal region in a 9-year-old child, which appeared as painless masses and rapidly growing within one year. Penile ultrasonography suggested well-defined lesions with limited vascularity. Both masses presented with low-to-intermediated signal intensity and no definite enhancement in computed tomography. The lesions were completely resected with minimal intraoperative bleeding, and a diagnose of benign PS was confirmed based on H&E staining and positive S-100 expression in immunohistochemistry. There was no evidence of tumor recurrence or metastasis after 6 months of follow-up. Only 6 cases of penile schwannoma in children were recorded, of which 5 were malignant, and none was PS. The malignancy rate of penile schwannoma in children may be overestimated due to delayed diagnose of benign ones. A rapidly growing penile mass with a suspected metastatic lesion in inguinal region could be easily misdiagnosed as malignant. This case report and literature review is expected to assist clinicians in getting a comprehensive understanding of children penile schwannomas and choosing the best management strategy when faced with this rare condition.
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Affiliation(s)
- Xiaoying Qi
- Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yifei Tan
- Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yanru Feng
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Dan Ma
- Department of Ultrasound, Meishan Women and Childrens’ Hospital, Alliance Hospital of West China Second University Hospital, Sichuan University, Meishan, Sichuan, China
| | - Ling Wang
- Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Houqing Pang
- Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
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Yılmaz MŞ, Ulubay M, Kuru F, Akar ÖS. Multiple Penile and Scrotal Schwannomas in an Adult Patient: A Case Report. Urol Int 2024; 108:259-263. [PMID: 38290475 DOI: 10.1159/000535093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/23/2023] [Indexed: 02/01/2024]
Abstract
INTRODUCTION Schwannomas originate from the peripheral nerve sheaths and are mainly detected in the head, neck, or extremities. They are rarely encountered in the penoscrotal region. CASE PRESENTATION Herein, we present a case of a penoscrotal schwannoma diagnosed and successfully treated in our center. A 40-year-old patient with a history of resection of a dorsal penile schwannoma presented with multiple nodular lesions at the scrotum, penile shaft, and radix, which were first noticed 5 years before his current presentation. He complained about penile pain and dyspareunia. Magnetic resonance imaging was performed for preoperative diagnosis. All nodular lesions were resected while preserving the neurovascular structures. The histopathological examination revealed benign lesions. The patient's complaints were resolved, and there was no recurrence during the 1-year follow-up. CONCLUSION The primary treatment is surgical excision. The patients need close follow-up regarding the risks of recurrence and malignant transformation.
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Affiliation(s)
- Muhammet Şahin Yılmaz
- Department of Urology, Samsun University Samsun Training and Research Hospital, Samsun, Turkey
| | - Mahmut Ulubay
- Department of Urology, Samsun University Samsun Training and Research Hospital, Samsun, Turkey
| | - Fatih Kuru
- Department of Urology, Samsun University Samsun Training and Research Hospital, Samsun, Turkey
| | - Ömer Salih Akar
- Department of Medical Genetics, Ondokuz Mayıs University, Samsun, Turkey
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Song Z, Zhang Z, Xu S, Qiu Y, Ouyang J. Multiple penile schwannomas. Urol Case Rep 2022; 43:102107. [PMID: 35586399 PMCID: PMC9109180 DOI: 10.1016/j.eucr.2022.102107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/30/2022] [Accepted: 05/04/2022] [Indexed: 11/21/2022] Open
Abstract
Penile neoplasm is uncommon, and multiple penile schwannomas are even rarer. We report a case of a 37-year-old man with multiple schwannomas on the left side of the penis, which had been present for more than 10 years without significant enlargement during erection and had recently been associated with mild pain. Ultrasonography revealed several subcutaneous heterogeneous hypoechoic of penile, the larger of which was approximately 1.9 × 0.9 cm. The patient underwent penile mass excision, and pathology and immunohistochemistry confirmed that it was schwannoma. The patient was followed up for 3 years without recurrence or metastasis.
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Mejri R, Dali KM, KaysChaker, Mokhtar B, Ben Rhouma S, Nouira Y. Isolated penile schwannoma: A rare case report. Urol Case Rep 2022; 40:101866. [PMID: 34646741 PMCID: PMC8497845 DOI: 10.1016/j.eucr.2021.101866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 09/27/2021] [Indexed: 11/26/2022] Open
Abstract
Schwannoma is a benign nerve tumor composed of cells of the schwann nerve sheath. Only about twenty cases have been reported in the literature to our knowledge. We report an isolated case of schwannoma of the penis in a 56-year-old man who presented a nodule of the penis in the balanopreputial groove that had been progressively increasing in size for three years. Anatomopathological and immunohistochemical criteria allowed for a positive diagnosis. Treatment consisted of surgical excision followed by rigorous surveillance.
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Affiliation(s)
- Ramzi Mejri
- Departement of Urology, Hospital Mongi Slim La Marsa, Tunisia
| | | | - KaysChaker
- Departement of Urology, La Rabta Hospital, Tunisia
| | - Bibi Mokhtar
- Departement of Urology, La Rabta Hospital, Tunisia
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Kim SH, Ahn H, Kim KH, Kim DS, Yang HJ. Penile schwannoma mistaken for hemangioma: a rare case report and literature review. Transl Androl Urol 2021; 10:2512-2520. [PMID: 34295737 PMCID: PMC8261408 DOI: 10.21037/tau-21-239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/05/2021] [Indexed: 12/17/2022] Open
Abstract
Penile neoplasm is uncommon. Schwannomas of the penis are especially rare. For this reason, it is difficult to get an accurate impression to enable decision making. This report primarily deals with the mistaken diagnosis of hemangioma, to the surgery, and the follow-up in real-world. A 38-year-old male patient presented with a palpable mass in the penile root that increased in size with erection. One year after the mass had been found, the patient visited the hospital and complained that the mass was growing. Moreover, the patient explained that the mass seemed to increase during penile erection. On physical examinations, a 2 cm mass without tenderness was palpated in the left penoscrotal junction. About 2.1 cm in size, an isoechoic mass was observed next to the corpus cavernosum on ultrasonography. There was high vascularity inside of the mass. Excision and biopsy were decided upon. Following surgery, a schwannoma was confirmed by pathology. After three months, the patient did not complain of any symptoms and had normal erectile function. Most of these tumors are benign. By December 2020, 40 cases were reported, of which 6 were diagnosed as malignant. The most frequent occurrence site is the penile shaft. In all cases, surgical resection was performed and no recurrence was found. The aim of this case report is to assist clinicians in choosing the best treatment option when faced with this rare condition by discussing the radiological, pathological, and clinical course.
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Affiliation(s)
- Si Hyun Kim
- Department of Urology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Hyein Ahn
- Department of Pathology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Ki Hong Kim
- Department of Urology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Doo Sang Kim
- Department of Urology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Hee Jo Yang
- Department of Urology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
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Majumder A, Ahuja A, Chauhan DS, Paliwal P, Bhardwaj M. A clinicopathological study of peripheral schwannomas. Med Pharm Rep 2021; 94:191-196. [PMID: 34013190 PMCID: PMC8118219 DOI: 10.15386/mpr-1708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 11/27/2020] [Accepted: 12/17/2020] [Indexed: 12/14/2022] Open
Abstract
Aim and objective Schwannomas are benign neoplasms of neural origin with sporadic or syndromic occurence. They are commonly seen in cranial nerves. Peripheral schwannomas occur rarely and may have unique presentations. The aim of this study is to evaluate the clinico-pathological characteristics of peripheral schwannomas. Methods A retrospective cross sectional study of peripheral schwannomas excluding head neck region was conducted. The study group consisted of 18 cases which were recorded over a period of seven years. The corresponding data were collected from the archives of the Department of Pathology. Results Male to female ratio was 1:1. The average age of the cases was 47 years. The most common site was the upper limbs (55.55%) followed by lower limbs, chest and penis. The lesions mostly presented as painless swellings (62%). Histopathological examination revealed classic features of schwannoma. Secondary changes included cystic degeneration, foam cells, epitheloid cells, hyalinization, microcystic change and collection of plasma cells. All cases were confirmed by positive S100 staining. Conclusion Peripheral schwannomas may be missed due to its rarity and atypical presentations. Both clinicians and pathologists should be aware of this common entity at unusual sites for the proper management of the patients. Surgery is usually the treatment of choice.
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Affiliation(s)
- Ankur Majumder
- Department of Pathology, Atal Bihari Vajpayee Instititute of Medical Sciences (ABVIMS) & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Arvind Ahuja
- Department of Pathology, Atal Bihari Vajpayee Instititute of Medical Sciences (ABVIMS) & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - D S Chauhan
- Department of Pathology, Atal Bihari Vajpayee Instititute of Medical Sciences (ABVIMS) & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Purnima Paliwal
- Department of Pathology, Atal Bihari Vajpayee Instititute of Medical Sciences (ABVIMS) & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Minakshi Bhardwaj
- Department of Pathology, Atal Bihari Vajpayee Instititute of Medical Sciences (ABVIMS) & Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Harb-De la Rosa A, Bracamonte E, Chipollini J, Gretzer M. A Rare Case of Urethral Schwannoma. Urology 2020; 145:e1-e3. [PMID: 32890619 DOI: 10.1016/j.urology.2020.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 11/26/2022]
Affiliation(s)
| | - Erika Bracamonte
- Department of Pathology, The University of Arizona College of Medicine, Tucson, AZ
| | - Juan Chipollini
- Department of Urology, The University of Arizona College of Medicine, Tucson, AZ
| | - Matthew Gretzer
- Department of Urology, The University of Arizona College of Medicine, Tucson, AZ
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Huang LC, Wang HZ, Chu YC, Ng KF, Chuang CK. Clinicopathological Presentation and Management of Penile Schwannoma. Sex Med Rev 2020; 8:615-621. [PMID: 31926907 DOI: 10.1016/j.sxmr.2019.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Patients with penile schwannoma are rare and usually with variant presentations. No evidence-based clinical guideline exists for diagnosis or treatment. To put schwannoma into differential diagnoses of benign soft tissue lesions in the penis is important. AIM To analyze and categorize clinical, histopathological, and radiological presentations and apply possible explanation on several fields of penile schwannoma. METHODS We collected the English literature through the PubMed database of the National Library of Medicine up to October 2019. A newly diagnosed case in Chang Gung Memorial Hospital, Taiwan, was also included. This study categorized lesion locations into the penile body or shaft, glans, or penile root, dorsal or ventral. MAIN OUTCOME MEASURE The main outcome measure was to demonstrate clinical, pathological, ultrasonography, and MRI manifestations of penile schwannoma and perform immunohistochemistry staining that has not been performed among penile schwannomas. RESULTS We collected 40 cases. Data were arranged in tables. Clear descriptions were added on several fields of penile schwannoma in detail in Discussion. CONCLUSION Penile schwannomas are mostly located at the penile shaft and dorsum of the penis. Dyspareunia is the most reported complaint for sexual dysfunction. This study is the first study in the world to document the expressions of calretinin, SOX10, glial fibrillary acid protein, D2-40 (podoplanin), and cytokeratin AE1/AE3 in penile schwannoma and claims magnetic resonance imaging and pathologic presentations of penile schwannomas are synonymous with schwannomas from head to toe. The current patient may be the first to present with penile schwannoma with schwannomatosis. Huang LC, Wang HZ, Chu YC, et al. Clinicopathological Presentation and Management of Penile Schwannoma. Sex Med Rev 2020;8:615-621.
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Affiliation(s)
| | - Hong-Zhen Wang
- Department of Urology, Xiamen Chang Gung Memorial Hospital, Xiamen, China
| | - Yuan-Cheng Chu
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Kwai-Fong Ng
- Department of Pathology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Keng Chuang
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
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Plexiform Schwannoma of the Penis: A Rare Subtype of Genital Schwannoma. Case Rep Urol 2019; 2019:1752314. [PMID: 31073418 PMCID: PMC6470439 DOI: 10.1155/2019/1752314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/24/2019] [Accepted: 03/25/2019] [Indexed: 01/11/2023] Open
Abstract
Schwannomas are benign, encapsulated neurogenic tumors which present in diverse histological subtypes despite the limited variety of their cellular constituents. These include the cellular, ancient, cystic, epithelioid, melanotic, psammomatous, schwannoma with pseudoglandular elements, and plexiform varieties. The plexiform schwannoma (PS) represents 4.3% of all schwannomas. These lesions are commonly encountered in the head and neck region and are extremely rare in the penis. To the best of our knowledge only 34 cases of penile schwannomas have been reported and this is the 3rd case of plexiform penile schwannoma. A 39-year-old patient presented to our andrology outpatient clinic complaining for two painful penile nodules. The lesions were located on the dorsum of the penile shaft. His medical history was insignificant for penile trauma and sexual transmitted diseases. The masses measured 2x1 cm and 0.5x1 cm. After sonographic and magnetic resonance evaluation the patient was admitted to theatre and underwent topical resection of the lesions. Histopathology revealed plexiform schwannoma. Postoperatively, penile tenderness and hyperesthesia ensued which was managed with pregabalin administration and topical corticosteroids. Plexiform schwannomas are rare in the penile region. Surgical excision is inevitably the only way to diagnose and treat the lesions. They must be differentiated by a variety of malignant and benign clinical conditions. Topical excision suffices for oncological control and allows for acceptable functional outcomes.
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Leung AK, Barankin B, Leong KF, Hon KL. Penile warts: an update on their evaluation and management. Drugs Context 2018; 7:212563. [PMID: 30622585 PMCID: PMC6302884 DOI: 10.7573/dic.212563] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 11/17/2018] [Accepted: 11/22/2018] [Indexed: 01/02/2023] Open
Abstract
Background Penile warts are the most common sexually transmitted disease in males. Clinicians should be familiar with the proper evaluation and management of this common condition. Objective To provide an update on the current understanding, evaluation, and management of penile warts. Methods A PubMed search was completed in Clinical Queries using the key terms 'penile warts' and 'genital warts'. The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. Results Penile warts are caused by human papillomavirus (HPV), notably HPV-6 and HPV-11. Penile warts typically present as asymptomatic papules or plaques. Lesions may be filiform, exophytic, papillomatous, verrucous, hyperkeratotic, cerebriform, fungating, or cauliflower-like. Approximately one-third of penile warts regress without treatment and the average duration prior to resolution is approximately 9 months. Active treatment is preferable to watchful observation to speed up clearance of the lesions and to assuage fears of transmission and autoinoculation. Patient-administered therapies include podofilox (0.5%) solution or gel, imiquimod 3.75 or 5% cream, and sinecatechins (polypheron E) 15% ointment. Clinician-administered therapies include podophyllin, cryotherapy, bichloroacetic or trichloroacetic acid, oral cimetidine, surgical excision, electrocautery, and carbon dioxide laser therapy. Patients who do not respond to first-line treatments may respond to other therapies or a combination of treatment modalities. Second-line therapies include topical/intralesional/intravenous cidofovir, topical 5-fluorouracil, and topical ingenol mebutate. Conclusion No single treatment has been shown to be consistently superior to other treatment modalities. The choice of the treatment method should depend on the physician's comfort level with the various treatment options, the patient's preference and tolerability of treatment, and the number and severity of lesions. The comparative efficacy, ease of administration, adverse effects, cost, and availability of the treatment modality should also be taken into consideration.
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Affiliation(s)
- Alexander Kc Leung
- Department of Pediatrics, The University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
| | | | - Kin Fon Leong
- Pediatric Institute, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia
| | - Kam Lun Hon
- Department of Pediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong
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Isolated penis schwannoma: A rare case report. Urol Case Rep 2018; 21:12-13. [PMID: 30128295 PMCID: PMC6098192 DOI: 10.1016/j.eucr.2018.07.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 07/17/2018] [Accepted: 07/25/2018] [Indexed: 12/27/2022] Open
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Abstract
PURPOSE OF REVIEW Management of genitourinary malignancy is likely to encompass a large portion of most of the urologist's practice. The challenge for the modern urologist is not only in understanding the management of commonly seen genitourinary malignancies, but also in recognizing unusual variants and their differences in management. This is evermore important as new technologies have refined the ability to identify rare entities. This review presents a brief overview of the various genitourinary malignancy subtypes seen within urology. RECENT FINDINGS All major organ subtypes are highlighted along with an overview of the current understanding of their associated malignancies. An update on the current state management paradigms as well as future directions is also outlined. SUMMARY After reading this review, the urologist should have a deeper understanding of the breadth of disorders in genitourinary oncology and a clearer approach to the management of these problems. Additionally, ongoing avenues for research are highlighted.
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Kumar U, Jha NK. Schwannoma of the penis, presenting as a scrotal mass, rare entity with an uncommon presentation. Urol Ann 2017; 9:301-303. [PMID: 28794605 PMCID: PMC5532906 DOI: 10.4103/ua.ua_38_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Schwannomas are benign nerve sheath tumors that are seen either sporadically or in patients of neurofibromatosis. This tumor is common in head, neck, and extremities. Penis is a rare site for this tumor. To the very best of our knowledge, <34 cases of penile schwannoma have been reported in literature till now, but none had presented as scrotal mass. Here, we report a case of penile schwannoma in a 16-year-old male boy who presented in our outpatient department with a slowly growing scrotal mass. Our patient did not have any other feature of neurofibromatosis. The patient after investigation underwent surgical excision and had no recurrence on follow-up of 5 years.
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Affiliation(s)
- Ujwal Kumar
- Department of Urology and Renal Transplant, SMS Medical College, Jaipur, Rajasthan, India
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