Epidermoid cyst of the coronal sulcus mimicking penile cancer: a case report

Luigi Cormio,Antonio Traficante,Giuseppe Carrieri,Livia Fucci,Vito Mancini,Francesca Sanguedolce,Pantaleo Bufo,Paolo Massenio

doi:10.1186/1752-1947-8-179

Abstract

IntroductionEpidermoid cysts represent common benign tumors occurring anywhere in the body but very rarely in the penis. Only a few cases of penile localization have been reported in the literature so far, most of them being congenital and/or idiopathic, usually presenting in children as slow-growing, solitary, well-delimited cystic lesions. Here, we describe the case of a patient with a penile epidermoid cyst presenting as an ulcerated lesion of the coronal sulcus, thus mimicking penile cancer.Case presentationA 36-year-old Caucasian man presented with a three-month history of a rapidly growing asymptomatic ulcerated lesion in the ventral portion of the penile coronal sulcus. At surgical exploration, the area under the ulcerated lesion had a well-demarcated cystic shape; following its wide excision, an intraoperative histological examination revealed an epidermoid cyst. No recurrence had occurred at nine years of follow-up.ConclusionsRare benign tumors of the penis, like the described epidermoid cyst, may mimic cancer. Nevertheless, penile ulcerated lesions should always be surgically explored as wide excision and intraoperative histological examination remain the only means of obtaining a precise disease definition and, consequently, administering the appropriate treatment.

Highlights

Epidermoid cysts represent common benign tumors occurring anywhere in the body but very rarely in the penis
Penile ulcerated lesions should always be surgically explored as wide excision and intraoperative histological examination remain the only means of obtaining a precise disease definition and, administering the appropriate treatment
We report here the first case, to the best of our knowledge, of a penile epidermoid cyst presenting like an ulcerated lesion of the coronal sulcus, mimicking penile cancer

Summary

Conclusions

Epidermoid cysts of the penis are extremely rare. Most of reported cases occurred in children, suggesting the etiology of ‘primary’ penile epidermoid cysts being embryonic developmental defects, abnormal closure of the median raphe [1]. Say, they occurred after circumcision, hypospadias surgery, or penile girth enhancement surgery [6]; they are considered inclusion cysts secondary to surgical procedures that may incidentally leave islands of epithelium included in the subcutaneous tissue Reported cases of both primary and secondary penile epidermoid cysts presented as slow-growing, solitary, well-delimited cystic lesions with a smooth and soft appearance [1,3]. Our case is the first to involve the coronal sulcus Such a location makes the differential diagnosis with penile cancer even more difficult, as one does not expect to find a tumor normally arising from the infundibular part of hair follicles, like an epidermoid cyst, in a hairless area.

Introduction