矽膠注射後造成陰莖肉芽腫

陳怡璇^1,2、詹鎮豪¹、李永進¹、王巽玄¹、沈榮宗¹、曹耀軒¹、吳怡萱¹、耿俊閎¹

高雄市立小港醫院 泌尿部¹；高雄市立大同醫院 泌尿科²

Silicone Granuloma of Penis

Yi-Hsuan Chen^1,2, Jhen-Hao Jhan¹

Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan¹ ;Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan²

CASE DESCRIPTION:

    A 50-year-old man presented with difficult urination for more than three years, associated with penile ulceration. He had history of operation with subcutaneous liquid silicone injection over penile shaft, but denied any history of traumatic accident or infectious sign. Due to persisted dysuria with recent progression, he visited our hospital Urology out-patient department for help. Upon arrival, physical examinations showed severe swelling of penis and prepuce ulceration. The ulceration and penile swelling made the identification of urethral orifice difficult (Fig 1).

Laboratory studies revealed no sign of acute infection. He underwent pelvic computed tomography for further survey. The pelvic computed tomography disclosed a soft tissue with fluid-like lesion and local inflammation around penis and scrotum, highly suspected penile granuloma (Fig 2). We arranged resection of penile mass with well preservation of penile shaft, glans and urethra orifice. Circumcision was also performed after en-bloc resection of penile mass (Fig 3). The specimen was then sent for pathological examination and histopathological report described squamous cell carcinoma with free margin of malignant cells. Based on histopathologic result, the diagnosis of penile squamous cell carcinoma was confirmed. The patient recovered well after operation, and was under close surveillance at our out-patient department.