Intravascular Lobular Capillary Hemangioma in the Corpus Spongiosum

Lobular capillary hemangioma (LCH) or pyogenic granuloma is a very common benign vascular tumor. However, its etiology still remains unknown. This tumor classically arises from epithelium-lined tissue, such as skin and mucosa, but subcutaneous and intravenous variants have also been described. Intravenous LCH usually arises within the lumen of large caliber veins, but other intravascular examples have been reported in association with vascular malformations, namely port-wine stains and arteriovenous fistulas. A 54-year-old man presented after the sudden appearance of a subcutaneous nodule on his penile coronal sulcus. A partial biopsy disclosed a lesion with typical features of LCH but with the particularity of being located within the dilated vascular spaces of the corpus spongiosum. After the biopsy, the lesion completely regressed. Although no causal factor could be elicited, trauma was a possible trigger considering the site. Additionally, we speculate that perhaps the normal anatomy of the corpus spongiosum may mimic a similar "slow blood flow environment" found in some vascular malformations, thus providing a possible explanation for the unusual location of the lesion in our patient. This case represents, to our knowledge, the first intravascular LCH described in the corpus spongiosum. Awareness of this unusual intravascular variant of LCH is of paramount importance to avoid misdiagnosis and unnecessary treatment, because the lesion may resolve even if incompletely excised, like in this case.