Epitheloid sarcoma masquerading as Peyronie's disease

Area of Science:

• Oncology
• Urology
• Pathology

Background:

• Peyronie's disease is characterized by penile plaque, pain, and curvature.
• Penile masses can present similarly to Peyronie's disease, complicating diagnosis.
• Epithelioid sarcoma is a rare soft tissue sarcoma with potential penile involvement.

Purpose of the Study:

• To highlight the diagnostic challenges of penile epithelioid sarcoma.
• To emphasize the importance of considering malignancy in atypical penile lesions.
• To review the clinical course and management of a case of penile epithelioid sarcoma.

Main Methods:

• Case report of a 23-year-old male with a penile mass.
• Initial biopsy misinterpreted, leading to delayed diagnosis.
• Subsequent re-biopsy, histopathological examination, and imaging.
• Treatment involved surgery, chemotherapy, and radiotherapy.

Main Results:

• Initial diagnosis suggested Peyronie's disease; biopsy was erroneous.
• Epithelioid sarcoma confirmed on re-biopsy after 6 years.
• Disease progression with focal gangrene and pulmonary metastasis.
• Patient alive with disease 2 years post-treatment.

Conclusions:

• Penile sarcoma must be considered in patients presenting with symptoms suggestive of Peyronie's disease.
• Persistent or enlarging penile lesions warrant thorough investigation, including repeat biopsy.
• Multidisciplinary approach is essential for managing rare penile malignancies.
• Early and accurate diagnosis is critical for improving outcomes in penile sarcoma.