陰莖硬化性淋巴管炎

劉致毅^1,2、王巽玄^1,2

¹高雄市立小港醫院泌尿科；²高雄醫學大學附設中和紀念醫院 泌尿部

Sclerosing lymphangitis of the penis

Chih I Liu^1,2, Hsun Shuan Wang^1,2

Division of Urology,Kaohsiung Municipal Siaogang Hospital,Taiwan¹;

Department of Urology,Kaohsiung Medical University Hospital,Kaohsiung Medical University²

Present Illness:

A 41-year-old male patient presented to a urology clinic reporting a persistent penile pain of several weeks' duration. He denied engaging in vigorous sexual activity and reported the absence of dysuria, hematuria, fever, or penile meatal discharge. The patient had no prior history of sexually transmitted infections or urological disorders.

Lab and Physical examination:

His lab data showed no leukocytosis, elevated CRP, electrolyte imbalance, high fasting sugar. Nor did his urinalysis showed pyuria or hematuria. During the physical examination, the urologist identified tenderness and a cord-like induration beneath the skin adjacent to the coronal sulcus.

Diagnosis:

Considering the location and nature of the patient's symptoms, sclerosing lymphangitis was suspected—a condition characterized by inflammation and fibrosis of the lymphatic vessels in the penis. Diagnostic confirmation was sought through ultrasound and magnetic resonance imaging examinations, both of which provided evidence supporting the diagnosis of sclerosing lymphangitis.

Treatment:

The urologist prescribed painkiller to alleviate the patient's discomfort, and after several weeks, the lesion spontaneously resolved.

Discussion:

Sclerosing lymphangitis is a rare inflammatory condition affecting the lymphatic vessels, often observed in the genital or pelvic regions. While the exact cause remains unclear, it is typically associated with sexual activity or infections. The hallmark symptoms include painful nodules or cords along the lymphatic vessels. It is generally a self-limiting condition, resolving on its own over time, symptomatic relief and reassurance are often provided. In severe or persistent cases, anti-inflammatory medications may be considered. Further research is needed to better understand the underlying mechanisms and to refine treatment approaches for this uncommon but discomforting condition.

Conclusion:

Sclerosing lymphangitis typically follows a benign course, resolving without complications. It is crucial to make differential diagnosis between Mondor's disease of the penis and sclerosing lymphangitis of the penis.