Urethral cavernous hemangioma: a highly misdiagnosed disease (a case report of two patients and literature review)

Abstract

BackgroundDiagnosis of urethral cavernous hemangioma (UCH) is very rare. It can be easy to misdiagnose and mistreat due to its atypical clinical manifestations and a lack of relevant knowledge. The study is to explore the diagnosis, differential diagnosis, and treatment of UCH.Case presentationThe first patient was a 15-year-old male, who was admitted to the hospital for more than 1 year with repeated hematuria. UCH was diagnosed by cystoscope biopsy, and cured with local injection of pingyangmycin. The second patient was a 49-year-old male, who was admitted for repeated painless gross hematuria and intermittent urethral bleeding after penile erection for more than 20 years. The case had been misdiagnosed as seminal vesiculitis, urethritis, or prostatitis, for over 20 years, until it was diagnosed as UCH by MR examination of the penis. It was treated by injection of pingyangmycin into the hemangioma’s lumen and base. A small incision in the ventral penile area was separated from the location of the hemangioma, which was injected with pingyangmycin again. A biopsy of resected tissue further confirmed the diagnosis of UCH.ConclusionsUCH is an easily misdiagnosed disease. Intermittent painless hematuria is important characteristic of UCH. Local injection of pingyangmycin is a good option for treatment of UCH.Electronic supplementary materialThe online version of this article (10.1186/s12894-019-0441-0) contains supplementary material, which is available to authorized users.

A rare glans cavernous hemangioma in young patient: A case report

“…Yong f et al [7] reported two cases of multiple treatments with hematuria, and finally diagnosed urethral cavernous hemangioma. At the same time, it also warned that sexual life may lead to rupture and bleeding of the tumor.…”

Urethral hemangioma: How to investigate as a cause of hematuria after male sexual activities

“…10 Fang et al reported that patients with urethral hemangioma in local hospital settings have received misdiagnoses such as seminal cystitis, urethritis, or prostatitis. 12 Urologists should bear in mind that the most common symptoms associated with urethral hemangioma include intermittent hematuria and, frequently, indolence. Additionally, it is essential to recognize the potential for hematuria to develop after erection and ejaculation.…”

One rare case of posterior urethral hemangioma and review of the literature

“…The growth of angiomas is limited because of the tissue of the urethral corpus cavernosum semi-encapsulated around the glans and corpus cavernosum of the penis and the relative depth of the penis. 2 Urethral Hemangioma usually has no obvious clinical manifestations. However, if it breaks through to the urethra, symptoms become apparent after erection or after ejaculation, making sarcoid hematuria the most important clinical feature of this disease.…”

“…Young men are more sexually active, so the disease is highly detectable but needs to be differentiated from vesiculitis. 2 In female patients, it is more often seen with the finding of urethral masses or vaginal bleeding.…”

“…In Fang Yong et al for pelvic MRI, preoperative penile sagittal MRI showed a high signal in the urethral cavernosa anterior to the penis. 2 Therefore, penile MRI helps determine the extent of Hemangioma to facilitate the surgeon to develop a surgical plan and have a regular assessment of the treatment outcome. In this report, a pelvic MR plain scan was performed in patient, however, no hemangioma was found in either case, which may be related to the location and the size of the lesion.…”