High-flow priapism due to a malignant glomus tumor (glomangiosarcoma) of the corpus cavernosum.
BACKGROUND
The major cause of non-ischemic high-flow priapism is post-traumatic vascular injury leading to an arterio-lacunar fistula. However, rare causes such as tumors may induce priapism. This is the first report of a malignant glomus tumor localized in the corpora cavernosa.


OBJECTIVE
The aim of this case is to emphasize the importance of the initial management of priapism and to suggest new tracks on the tests to be performed when the usual exams are not sufficient.


METHODS
We report the case of a hypervascular penile tumor responsible for high-flow priapism as the first clinical symptom of a metastatic glomus tumor. The persistent penile tumescence was initially considered to be a stuttering priapism and treated using an oral α-adrenergic as no provoking event nor fistula was found. After a 2-week reluctance, a penile magnetic resonance imaging (MRI) was performed.


RESULTS
The MRI showed a hypervascular lesion at the proximal part of the right corpora. The lesion was considered as a fistula, and a selective embolization was performed. Two weeks after embolization, the patient came back to the emergency room because of syncopes and dyspnea. Examination by cardiac ultrasound and chest computed tomography revealed the presence of cardiac, pulmonary, and subcutaneous malignant glomus tumors (glomangiosarcoma). Patient received three lines of chemotherapy, and the penile tumor was surgically removed because of persistent erectile dysfunction and perineal pain.


CONCLUSIONS
This case supports the use of corporal body blood gas analysis in difficult cases to discriminate high- and low-flow priapism and penile MRI when clinical history, physical examination, and aspiration are not contributory.
Masson-Lecomte
Alexandra
A
Bicêtre Academic Hospital--Paris XI University, Urology Department, Le Kremlin Bicêtre, France.
Rocher
Laurence
L
Ferlicot
Sophie
S
Benoît
Gérard
G
Droupy
Stéphane
S
D000328:Adult; D005918:Glomus Tumor / Q000150:complications* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010410:Penile Erection; D010412:Penile Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D010413:Penis / Q000098:blood supply / Q000473:pathology*; D011317:Priapism / Q000209:etiology* / Q000473:pathology / Q000601:surgery