Neurofibroma and epidermoid cyst: unexpected findings after first foreskin retraction

Primary solitary neurofibroma of penis in a child: case report and review

Background

Genital involvement in neurofibromas is rare and can involve both the clitoris and penis; in the latter, it usually accompanies a systemic pathology. Isolated penile neurofibroma is anecdotal. This report presents an unusual solitary penile neurofibroma in a child, discusses its surgical management and reviews the literature.

Case presentation

A 6-year child presented with history of swelling on the undersurface of his penis and obstructive voiding symptoms since 18 months of age. He underwent a partial excision at 5 years of age elsewhere which recurred. The swelling was a 3 × 2 cm, firm, midline, smooth surfaced, longitudinally oblong mass over the ventral penis extending from root to mid shaft with restricted mobility. There was no inguinal lymphadenopathy. Ultrasonography and cystoscopy characterized it to be a corpus spongiosal soft tissue mass encasing and indenting the contained penile urethra. The mass was completely excised along with involved urethra and corpus spongiosa and a penoscrotal urethrostomy created. Histopathological analysis revealed it to be a benign nerve sheath tumor/neurofibroma. He had no stigmata of neurofibromatosis and the ophthalmologic examination was unremarkable. At 2-year follow-up, he is well, has normal glanular sensation and erectile function and awaits urethral reconstruction.

Conclusion

Primary solitary penile neurofibroma in children is extremely rare. This report details the presentation and management of a ventral penile neurofibroma involving the adjacent urethra/corpora spongiosa.