Epithelioid sarcoma of the penis: report of an unusual case and review of the literature.
Epithelioid sarcoma is a rare, slowly growing soft tissue tumor that uncommonly involves the penis, with only 11 previously reported cases. We present a case of penile epithelioid sarcoma in a 39-year-old man that mimicked Peyronie's disease, which was diagnosed 13 years following initial presentation. Preoperative magnetic resonance imaging showed multiple peripherally enhancing low signal intensity nodules involving the corpora cavernosa bilaterally. Following penectomy, histologic examination showed the typical features of epithelioid sarcoma, with a prominent pseudogranulomatous pattern. Immunohistochemically, the neoplastic cells demonstrated strong and diffuse staining for cytokeratins (AE1/AE3 and CAM 5.2), vimentin, epithelial membrane antigen, and CD34. Stains for S-100 protein, desmin, smooth muscle actin, and CD31 were negative. Electron microscopy demonstrated abundant intracytoplasmic intermediate filaments, scattered tonofilaments, and interdigitating filopodia. The present study is the first to describe magnetic resonance imaging and comprehensive immunohistochemical findings in penile epithelioid sarcoma. The majority of cases reported in the literature have demonstrated features similar to those typically found in epithelioid sarcoma involving the distal extremities. Consideration of epithelioid sarcoma in the differential diagnosis of a penile nodule or obstructive urinary symptoms may lead to early diagnosis and treatment.
Ormsby
A H
AH
Department of Anatomic Pathology, The Cleveland Clinic Foundation, OH 44195, USA.
Liou
L S
LS
Oriba
H A
HA
Angermeier
K W
KW
Goldblum
J R
JR
D000328:Adult; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D010411:Penile Induration / Q000175:diagnosis* / Q000473:pathology* / Q000503:physiopathology; D010412:Penile Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D011859:Radiography; D012509:Sarcoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology