A rare and unique manifestation of a huge penile tumor , think traumatic origin : a case report and review of literature

Giant fibroepithelial polyps of mesodermal and ectodermal origin are rare benign tumors of the penis; mostly exhibiting aggressive growth patterns and known classically to be one of the transformable forms of advanced penile cancer with high capabilities of forming a spectrum of heterogeneous lesions. There are currently only a few reported cases in the medical literature. We present a single case of a 57-year-old man born and raised in a tropical island of Southern China with symptomatic urinary retention due to an enlarging penile mass on the glans of the penis of approximately 19 years duration, which was associated with post-trauma-induced paraplegia of the lower limbs and subsequent urogenital infections. The patient had notable general history, followed by consultation for more than four years of aggressive penile mass not improving under the patient’s decision to resort only to usual home treatments. He was reconciled when his symptoms worsened and the biopsy examination revealed a possible penile fibromatosis, there was no known metastasis on systemic examination as the mass was localized on the glans of the penis from the top to the base, with no obvious palpable mass or bumps on both sides of the scrotum. The penile mass was large, measuring 18 × 9 centimeters by length and width, as its thickest part is covered with cauliflower-like lumps which are hard in texture and are pink to reddish-brown. On excision of the tumor perioperatively, the corpus cavernosum and urethral cavernous body were exposed, and there was a fistula of about 0.3cm*0.2cm on the surface of the cavernous urethra, consistent with penile fibromatosis of the penis, with highly important clinical characteristics of value to medical literature during the supportive therapy, surgical total radical resection and urethroplasty of the penis. This case report is the longest and largest mass of its kind to be reported on the penis. It provides guidance for the clinical treatment and research of penile cancer.