Sclerosing lipogranuloma of penis: Case report

Abstract

Introduction: Increasing the volume of penis by injecting various substances (paraffin, silicone, mineral oils) remains a highly controversial procedure. This procedure is usually performed by patients themselves or by persons without a licensed medical education. Injecting these substances causes a local inflammatory reaction with redness, pain, swelling, thickening of penile skin, with the subsequent formation of sclerosing lipogranuloma, In more serious cases ulceration, necrosis, embolism and even death may occur. Impotence, painful erections and dysuria are the most common symptoms. The treatment is excision with subsequent reconstruction, while the conservative approach using antibiotics has a limited effect. Case report: A 45-year-old patient presents to Emergency Department due to lesions on penis. Inspection showedscarring with ulcers and signs of inflammation on ventral side of penis, and patient was referred to urologist. Part of the scar tissue with inflammation was excised, biopsy was taken, and reconstruction was made. Pathohistological analysis revealed fragments of skin and subcutaneous connective tissue. Ulcerations with inflammatory infiltrate, hyperkeratosis and parakeratosis were present on parts of epidermis. Inflammatory infiltrate rich in epithelioid histiocytes with lipid vacuoles was present in subcutaneous connective tissue, and smaller foci of necrosis and cystic changes in the form of "Swiss cheese" were observed. Based on pathohistological findings and clinical data, he was diagnosed with sclerosing lipogranuloma. Conclusion: Increasing the volume of penis by injecting substances is very dangerous. In extreme cases this procedure can even result in death, and will never provide the expected , satisfying results to the patients.