Kim JY, Kim JY, Park M, Oh CK, Chung JS, Park SH, Kim SC. Surgical managements of pseudoepitheliomatous keratotic and micaceous balanitis: A case report.
Int J Surg Case Rep 2019;
55:37-40. [PMID:
30684817 PMCID:
PMC6351345 DOI:
10.1016/j.ijscr.2018.12.008]
[Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 12/29/2018] [Indexed: 11/24/2022] Open
Abstract
Pseudoepitheliomatous keratotic and micaceous balanitis is rare and had the distinctive clinical findings.
Deep biopsy is needed to diagnose the accurate tumor staging.
Glansectomy with split-thickness skin graft can be performed to treat and diagnose.
Introduction
Pseudoepitheliomatous keratotic and micaceous balanitis (PKMB) is an extremely rare disease. Herein, we report a case of PKMB in a patient who underwent two surgical procedures, since the 5-FU cream was not available.
Presentation of case
A 50 year-old Korean man undergoing circumcision in a local clinic presented with a tumor-like lesion on the glans penis. Peeling the mass was performed to remove the entire mass after an excisional biopsy. A pathologic finding of mass showed hyperkeratotic and papillomatous squamous epithelium without obvious cytologic atypia. Considering that the lesion recurred after 4 weeks, the patient underwent glansectomy with split-thickness skin graft (STSG). There had been no evidence of recurrence at the surgical site during the follow-up at 6 years postoperatively.
Discussion
If the 5-FU cream is not available, two surgical procedures can be performed for treatment and biopsy. Peeling the mass has the advantage of confirming the characteristics of the whole lesion, but it cannot confirm tumor invasion because it is unable to obtain the subepithelial layer. Glansectomy is able to accurately identify the tumor stage because it removes the tumor and total glans penis and has excellent outcome.
Conclusion
PKMB is very rare and has a characteristic appearance, which is mica-like crusts and keratotic horny mass on the glans penis. Glansectomy with STSG is a good procedure when the 5-FU cream was not available.
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