title: Necrotizing granulomatous inflammation of the glans penis.
abstract: We describe the case of a 73-year-old man who presented with a 10-month history of an ulcerating lesion on the glans penis. Initially this was thought to be an invasive squamous cell carcinoma but a biopsy showed histological features consistent with necrotizing granulomatous inflammation. Extensive serological, immunological and microbiological tests only showed a positive antinuclear and perinuclear antineutrophil cytoplasmic antibodies indicating a possible autoimmune aetiology but an underlying systemic cause was not identified. Treatment with oral corticosteroids limited the inflammatory process but due to the gross destruction of the glans penis, he still required a glansectomy and split-skin graft reconstruction from which he recovered well. Although this patient ultimately required surgery for this rare presentation, this case highlights the differential diagnosis of penile ulceration (that transcends neoplasia) and the importance of performing and interpreting penile biopsies before undertaking potentially mutilating definitive surgery.
authors: Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK.
authors: Michelle
authors: M
authors: Christodoulidou
authors: Department of Dermatology, University College London Hospitals NHS Foundation Trust, London, UK.
authors: Christopher B
authors: CB
authors: Bunker
authors: Department of Pathology, University College London Hospitals NHS Foundation Trust, London, UK.
authors: Giorgia
authors: G
authors: Trevisan
authors: Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK.
authors: Asif
authors: A
authors: Muneer
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001446:Balanitis / Q000473:pathology*; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D003937:Diagnosis, Differential; D006099:Granuloma / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010412:Penile Neoplasms / Q000473:pathology; D010413:Penis / Q000473:pathology*; D011239:Prednisolone / Q000008:administration & dosage
chemical_list: D000893:Anti-Inflammatory Agents; D011239:Prednisolone