Intralesional sclerotherapy in the management of hemangiomas of the glans penis

Venous malformation of the penis treated with a combined Nd:YAG laser and sclerotherapy technique

Venous malformations are the commonest vascular anomalies and can be found everywhere in the body. Those of the external genitalia are quite rare. Although they can be small, they may give rise to psychological discomfort and functional impairment and their management can be delicate and challenging. We present a case of a large and infiltrating venous malformation of the glans penis successfully treated with a combined strategy using sclerotherapy and Nd:YAG laser.

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.

Ulcerated Scrotal Hemangioma in an 18-Month-Old Male Patient: A Case Report and Review of the Literature

Deep scrotal hemangiomas are rare. Less than 50 case reports have been published. After systematic research of the literature, we found less than 5 cases of ulcerated scrotal hemangioma. The aim of this case report is to illustrate the challenges of scrotal hemangiomas pose and their potential therapies based on the successful surgical treatment of an ulcerated scrotal hemangioma in an 18-month-old male patient.

Large Genital Cavernous Hemangioma: A Rare Surgically Correctable Entity

We report a case of 24-year-old male presenting with painless penoscrotal swelling for 3 years. On examination, a large soft bag of worm-like, superficial, nonpulsatile swelling was present in scrotum and penis. Color Doppler showed dilated tortuous vessels and on angiography no connections to corpora or vessels were seen. So a diagnosis of hemangioma was made and a surgical excision was carried out by circumcoronal and scrotal incisions. Postop course was uneventful. At 6 months of follow-up, no recurrence was seen and wound had healed with excellent cosmetic appearance.

Cavernous hemangioma of the glans penis

Cavernous hemangioma of the glans penis is a very rare lesion, and only a few cases are reported in the literature. Urologists are in a dilemma to treat such lesion with cosmetic and to obtain good functional outcome. Here, we report a case of cavernous hemangioma of the glans penis in a 22-year-old boy with a successful outcome by intralesional sclerotherapy with 3% sodium tetradecyl sulfate with a review of the literature on the subject.

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.

Intralesional bleomycin injection treatment for vascular birthmarks: a 5-year experience at a single United Kingdom unit

BACKGROUND

The authors present their experience using an established chemotherapeutic agent as a scarless treatment for vascular birthmarks. One hundred sixty-four of more than 600 patients seen in the authors' center received intralesional bleomycin injection over 5 years.

METHODS

Patient demographics, clinical response, treatment, and complication details were recorded prospectively. Respiratory surveillance was provided by adult and pediatric pulmonologists. Eighty-one venous malformations, 39 hemangiomas, 26 lymphatic malformations, 10 mixed malformations, two arteriovenous malformations, two cystic hygromas, two capillary malformations, and two angiokeratomas underwent intralesional bleomycin injection.

RESULTS

The authors observed that 45.7 percent of patients completed treatment in a mean of 3.8 sessions and mean duration of 107 days. Complete resolution occurred in 56.0 percent, with a 93.3 percent overall response rate, and 82.7 percent of lesions demonstrated complete response or significant improvement. Three patients developed transient skin hyperpigmentation. One patient each developed skin ulceration, blistering, infection, swelling, headache, bruising, and rash. One patient required intubation following treatment of a panfacial and thoracic lymphatic malformation. A full recovery ensued. No patients developed pulmonary fibrosis. One venous malformation recurred.

CONCLUSIONS

The authors' single-site multidisciplinary team has successfully treated complex and recurrent vascular anomalies with acceptable complication and recurrence profiles. These findings represent the authors' experience and provide a reference for the management of these challenging lesions.

Venous malformations of the genitals: a therapeutic dilemma

Venous malformations may occur anywhere in the body but are rare in the genitourinary tract and external genitalia. The authors report a case of a venous malformation in the glans penis and discuss the controversy over optimal management.

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

Hemangiomas of the urinary tract are rare lesions, and those of the glans penis are even rarer. A 23-year-old man with a hemangioma of the glans penis treated successfully with intralesional sclerotherapy is presented. Other options for the management of this disorder are discussed.

An unusual cause of paraphimosis: hemangioma of the glans penis

Paraphimosis is a urologic emergency that occurs in uncircumcised boys. In untreated paraphimosis, increasing edema caused by vascular and lymphatic obstruction results in ominous sequelae such as penile gangrene, which leads to autoamputation in days or weeks. Most cases of paraphimosis are iatrogenic, but that condition has unusual causes as well. We present a very rare case of paraphimosis that occurred in a patient with a hemangioma of the glans penis. We suggest that the swelling of the hemangioma pushed the penile skin backward and caused paraphimosis. To our knowledge, such a presentation has not been previously reported in the English literature.

Role of Intralesional Bleomycin in the Treatment of Complicated Hemangiomas: Prospective Clinical Study

BACKGROUND

Hemangioma is the most common tumor of infancy. Although it has a basically benign nature and usually spontaneously regresses, a small percentage (5%) have complications that need treatment. Many different therapeutic modalities can be used in this tumor.

OBJECTIVE

To investigate the effect of a new method of treatment (intralesional bleomycin injection) in complicated hemangiomas.

MATERIALS AND METHODS

In the Department of Radiation Oncology at Nemazee Hospital in Shiraz, Iran, from April 1992 to October 1998, 32 patients with complicated hemangioma were treated with four to six courses of direct injection of bleomycin into the lesion.

RESULTS

After a minimum follow-up of 6 years, there was 70 to 100% regression in 18 patients, 50 to 70% in 7 cases, and less than 50% reduction in 7 patients.

CONCLUSION

Intralesional injection of bleomycin is an easy, safe, and effective therapeutic modality in complicated cutaneous hemangiomas.

Ablation of Liver Tumor by Injection of Hypertonic Saline

OBJECTIVE

The objective of our study was to evaluate the efficacy of hypertonic saline for the treatment of liver tumors.

MATERIALS AND METHODS

Thirty New Zealand white rabbits inoculated with VX2 carcinoma in the liver were included in this experiment. These animals were divided into two groups: one for the evaluation of survival time (n = 20) and the other, for tumor size (n = 10). Each group was divided further into control and treatment subgroups. Hypertonic saline was injected directly into the liver tumor of the treatment group under CT guidance 10 days after inoculation. The liver tumor in the control group was injected with normal saline. The group for evaluation of tumor size was sacrificed 14 days later. The other group was raised until they died.

RESULTS

The survival time of the rabbits in the treatment group (38.1 +/- 2.3 days) was significantly longer (p < 0.001) than that of the untreated group (29.9 +/- 2.9 days). For tumor size, the difference between the treatment group (8.04 +/- 2.46 cm(2)) and the control group (11.08 +/- 2.52 cm(2)) was also significant (p < 0.05).

CONCLUSION

Hypertonic saline injection had the effect of controlling the growth of VX2 carcinoma cells and extending the life of rabbits. It deserves further investigation.

Sclerotherapy of hemangioma of the glans penis

Penile hemangiomas are very rare, small lesions. Possible therapies include surgical excision, electrofulguration, cryotherapy, and sclerotherapy. We describe an extremely rare case of a large hemangioma of the glans that was treated by means of repeated injections of 2% polidocanol under local anesthesia (5% lidocaine-prilocaine cream). No complications were observed after the operation, and a satisfactory aesthetic result was obtained. No relapse was noted 18 months after the treatment. A therapeutic reference standard for the treatment of penile hemangiomas is still lacking because of the rarity of the disease. Sclerotherapy proved to be an effective, low-cost, and easy-to-perform procedure. Moreover, it is repeatable in case of failure.