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Necrotizing granulomatous inflammation of the glans penis

Christodoulidou, M; Bunker, CB; Trevisan, G; Muneer, A; (2016) Necrotizing granulomatous inflammation of the glans penis. BMJ Case Report , 2016 , Article bcr2016216913. 10.1136/bcr-2016-216913. Green open access

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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.

Type: Article
Title: Necrotizing granulomatous inflammation of the glans penis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bcr-2016-216913
Publisher version: http://doi.org/10.1136/bcr-2016-216913
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Administration, Oral, Aged, Anti-Inflammatory Agents, Balanitis, Biopsy, Carcinoma, Squamous Cell, Diagnosis, Differential, Granuloma, Humans, Magnetic Resonance Imaging, Male, Penile Neoplasms, Penis, Prednisolone
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Surgical Biotechnology
URI: https://discovery.ucl.ac.uk/id/eprint/10063236
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