黃亮臻、吳桂芳¹、莊正鏗²

長庚大學 醫學系；林口長庚紀念醫院 解剖病理科¹，外科部 泌尿外科²

Liang-Chen Huang, Kuei-Fang Wu¹, Cheng-Keng Chuang²

School of Medicine, Chang Gung University, Taiwan; ¹Department of Pathology and ²Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan

 

Schwannoma of the penis is extremely rare. This is a case of a 56-year-old male who presented with a tender indurated perineal mass. Magnetic Resonance Urography showed a heterogeneous mass lesion in the base of the penis, involving part of right penile bulb and right corpus cavernosum with extension to perineal area, measuring 5.3 x 2.9 x 2.5 cm in size. This mass also displaced corpus spongiosum to the left. There was no dysuria, erectile dysfunction, or abnormal penile curvature while erection. Percutaneous needle biopsy disclosed a spindle cell tumor composed of bundles of spindle cells with wavy nuclei with occasional degenerated atypia, Verocay bodies, focal loose edematous areas, and focal hyalinized vessels. Tumor cells are diffusely and strongly positive for S-100 protein. He was subsequently diagnosed with penile root schwannoma.

Other three small enhancing lesions in the dorsum of the penis and a small right epididymal cyst were also noted on the image. Penile-preserving local excision was suggested but patient hesitated. The lesions on the dorsal penis was unpalpable along the penis shaft, if they are also schwannomas, they are different from other cases of schwannoma on the dorsum of penis, most of them are palpable masses.

This will be the first documented case of penile root schwannoma in Taiwan, only less than ten cases of penile root schwannoma have previously described in English-language literature. This clinical presentation is unique to our specialty.