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PET scan showing hypermetabolic bilateral inguinal (A) and retroperitoneal lymphadenopathies (B).
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A positron emission tomography-computed tomography (PET-CT) scan demonstrated the presence of a 4 cm hypermetabolic penile mass along with multiple hypermetabolic bilateral inguinal and pelvic lymph nodes of less than 2 cm (Fig. 1, Fig. 2).
Macroscopic specimen. Note the yellow necrosis (red arrow) visible at the superior portion of the lesion. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article).
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Given the severe intractable penile pain and considering that the patient had been abstinent for over 10 years, the decision was taken to perform a partial penectomy for palliative and diagnostic purposes (Fig. 3).
Granuloma (encircled). (x20).
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Pathological assessment of the specimen revealed the presence of polymorphous, granulomatous, epitheloid inflammatory infiltrate with giant cells, associated with a focal abscess and a prominent vascular involvement (Fig. 4, Fig. 5, Fig. 6).
Peri-abcess macrophages granuloma.
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Pathological assessment of the specimen revealed the presence of polymorphous, granulomatous, epitheloid inflammatory infiltrate with giant cells, associated with a focal abscess and a prominent vascular involvement (Fig. 4, Fig. 5, Fig. 6).