Abstract
BackgroundPenile swellings are not very common. They usually present as an obvious lesion visible and palpable either on the penile shaft, glans, or prepuce. Rarely, benign swellings may be concealed by phimosis and can present as “club” penis.Case presentationWe report the case of a 30-year-old Indian male man who presented with the complaint of difficulty in retracting his foreskin and a club-shaped distal penis. There were palpable lumps on either side of the glans penis which were concealed by the foreskin; hence, a proper preoperative clinical diagnosis was not possible. Circumcision revealed the presence of two discrete cystic swellings from inner prepuce which were excised. Histopathology was suggestive of epidermoid cysts.ConclusionsAlthough epidermoid cysts are common cutaneous swellings, they are rarely seen on the penis. They generally present as a small solitary swelling on the penile surface and occurrence at multiple sites is very rare. Epidermoid cysts arising from inner prepuce, hiding within and presenting as club penis have not been reported. Thus, benign lumps should be considered an etiology for phimosis.
Highlights
We report a case of a young adult who presented with the complaint of difficulty in retracting his foreskin and a “club”-shaped distal penis
There were palpable lumps on either side of the glans which were concealed by the foreskin; a proper preoperative clinical diagnosis was not possible
Our patient had a smooth postoperative recovery and at follow-up the wound had healed primarily. Histopathology revealed both swellings as unilocular cysts with lamellated keratin and lined by stratified squamous epithelium suggestive of epidermoid cysts (Fig. 4)
Summary
Epidermoid cyst of the penis is very rare. It can be multifocal and even originate from inner prepuce. Multiple or large epidermoid cysts at this site can affect the retractability of the foreskin resulting in phimosis. Concealed penile tip swellings are clinically difficult to interpret. For a young adult with a club-shaped penis and phimosis, benign etiologies such as multiple epidermoid cysts from inner prepuce have to be considered
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