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Pediatric penile tumors of mesenchymal origin
Brian H Eisner1, Sarah J McAleer, Patricio C Gargollo
1Department of Urology, Children's Hospital Boston, Boston, Massachusetts, USA. beisner@partners.org
Insights
Pediatric penile masses can be rare mesenchymal tumors. Surgical excision is often curative for these penile tumors, but malignant cases require vigilant follow-up for recurrence.
Area of Science:
- Pediatric Urology
- Surgical Oncology
- Dermatopathology
Background:
- Mesenchymal tumors of the male external genitalia are exceptionally rare.
- Early diagnosis and treatment are crucial for pediatric penile masses.
Observation:
- Two pediatric patients presented with painless, growing penile masses at the penoscrotal junction.
- Case 1: A 13-year-old boy with a malignant tumor comprising dermatofibrosarcoma protuberans, giant cell fibroblastoma, and fibrosarcoma.
- Case 2: An 11-month-old infant with a benign myofibroma, a congenital fibroblastic tumor.
Findings:
- Histopathological and immunohistochemical analysis confirmed the distinct tumor types.
- The malignant penile tumor (Case 1) required wide reexcision.
- Both patients achieved successful outcomes with no recurrence after extensive follow-up periods.
Implications:
- Mesenchymal tumors must be considered in the differential diagnosis of pediatric penile masses.
- Surgical resection is the primary treatment modality.
- Close monitoring for recurrence is essential for patients diagnosed with malignant penile tumors.
Objectives:
To describe 2 cases of mesenchymal pediatric penile tumors in a 13-year-old boy and an 11-month-old infant. Mesenchymal tumors are rare in the male external genitalia.
Methods:
Two patients, one aged 13 years and one 11 months, presented with painless penile masses at the penoscrotal junction. The evaluation included serial clinical examinations and ultrasonography. Both lesions were surgically excised after increasing in size. Because of malignancy, the first patient underwent wide reexcision of the tumor site.
Results:
The pathologic findings of the first case were combined dermatofibrosarcoma protuberans, giant cell fibroblastoma, and fibrosarcoma, a malignant tumor. Immunohistochemical staining showed strong and diffuse CD34 cytoplasmic positivity in the giant cell fibroblastoma and dermatofibrosarcoma protuberans components; the dedifferentiated fibrosarcoma tumor cells were negative for this antibody. The second case was myofibroma, a benign fibroblastic tumor with a prominent myofibroblastic component that is congenital and tends to occur within the first few months after birth. Neither patient had recurrence at 16 months and 3 years of follow-up. To our knowledge, this is the first reported case of combined dermatofibrosarcoma protuberans, giant cell fibroblastoma, and fibrosarcoma of the penis and the second reported case of isolated penile myofibroma.
Conclusions:
Penile tumors should be included in the differential diagnosis of pediatric penile masses. Surgical resection is often curative, but patients with malignant tumors should receive careful follow-up to monitor for recurrence.
