Penile Lymphangioma: review of the literature with a case presentation

Abstract

BackgroundPenile lymphangiomas are rare manifestations of lymphangiomas or lymphatic malformations which are more commonly found in the head or neck region of the body. Lymphangiomas are further categorized as lymphangioma circumscriptum, cavernous lymphangioma, cystic hygroma, or acquired lymphangiomas (also known as lymphangiectasia), based on their depth and etiology.ResultsA literature review revealed only 30 cases of penile lymphangioma between 1947 and March 30, 2018. Several causes were attributed to the acquired penile lymphangiomas, including trauma, phimosis, and infection. While penile lymphangiomas can be initially mistaken for an infection, a thorough history and physical examination is sufficient to clinically diagnose a lymphangioma of the penis. Historically, surgical excision has been the gold standard of treatment for this condition. When asymptomatic, patients may opt for conservative management with avoidance of mechanical trauma alone. Other physicians have revealed novel treatment plans to rid patients of their penile lymphangioma such as a staged laser procedure.ConclusionIn this article, we elucidate the causes, symptoms, treatments, and outcomes associated with penile lymphangiomas found in the literature while also presenting the case of a 30-year-old African-American man diagnosed with acquired penile lymphangioma.

Acquired Lymphangioma Circumscriptum of the Penis Treated by Electrocoagulation

“…Acquired cases appear to develop most frequently after infections of lymphatic channels, irradiation, or surgery [1]. In a recent review of the literature, Macki et al [2] reported only 8 cases of LC between 1947 and April 2018. Five of these were congenital and 3 were related to lichen planus, recurrent cellulitis, and ulcerative colitis.…”

Metabolic Syndrome and Reproduction

“…Males of infertile couples, defined according to the WHO [ 73 ], were investigated in nine studies [ 22 , 47 , 56 , 57 , 58 , 59 , 60 , 61 , 62 ]. IDF&AHA/NHLBI criteria were applied in three studies [ 47 , 60 , 61 ], whereas the AHA/NHLBI definition was used in one report [ 62 ], and NCEP-ATPIII criteria were used in five reports [ 22 , 56 , 57 , 58 , 59 ]. Ferlin et al [ 22 ] also showed a significantly higher frequency of MetS in men with a low sperm count compared to those with a normal one (8.1% vs. 6.6%, respectively).…”

Acquired lymphangioma circumscriptum in high-grade penile intraepithelial neoplasia

“…LC might be either congenital or acquired, and is predominantly located on the trunk, buttock, axillary region, or thighs. 1 Penile LC is rare. We report a case of acquired LC in a patient with high-grade penile intraepithelial neoplasia (PeIN).…”

“…5 Most cases of acquired LC have been reported in association with predisposing tissue alteration such as trauma, surgery, radiation exposure, chronic inflammation (e.g., hidradenitis suppurativa, inflammatory bowel disease, or recurrent cellulitis), or cancer. 1,5–7 Such alternations seem to hinder the subcutaneous lymphatic cisterns from completely draining into the general lymphatic system. 6 The association of acquired LC and penile HPV-induced lesions has been reported only once in a 24-year-old man with multiple genital HPV6-positive condylomata acuminata.…”

“…Vascular endothelial growth factor (VEGF) receptor is a key stimulator of lymphangiogenesis, and VEGF-receptor-2 has been shown to promote the development of lymphatic vasculature. 9 Interestingly, VEGF expression was shown to correlate with HPV-DNA load in cervical International Journal of STD & AIDS 32 (1) intraepithelial neoplasia. 10 Moreover, p16 INK4a stimulates lymphangiogenesis via upregulation of integrins in HPV-induced head and neck cancer.…”