Question Title: lymphangiectasia of penis

>>>>>>PREVIOUS POSTING:

: Topic Area: Urology - General
: : Last February, I was diagnosed as having a lymphagetic (sp?)
: : cyst on the top of my penis just behind the glans, and just
: : under the skin. This had been there for several years, not
: : causing a problem until last winter when pain started to occur.
: : The cyst was removed by a urologist a short time thereafter.
: : It was 1-2 mm in diameter and about 15 mm long. The urologist
: : said that the lymphatic tract on the top of the penis was
: : blocked from this. He said that in his career (I estimate this
: : to be about 25 years) he's only seen about three of these cases.
: : He said that the chances of reoccurance are negligible, and
: : it is unknown as to the cause. I have since made a full
: : recovery.

: : I have two questions. First, what additional information
: : can you give me regarding this phenomenon? How common is it?
: : Is it likely to return? What causes it? Etc.

: : Second, the urologist didn't do anything immediately after the
: : surgery to control my erections. This resulted in extremely
: : painful nights for about the first two weeks after surgery. A
: : good night's rest was impossible. He
: : later told me that he could've prescribed some type of hormone
: : therapy to control the erections. Could you give me any
: : additonal info on this?
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Dear Rick,

It is very important to have the pathological diagnosis (the diagnosis a pathologist makes after examining a
surgical specimen) on hand prior to making any prediction about the causes, nature, and prognosis (including
chances for recurrence) of a certain condition. I am not sure exactly what type of lesion you are referring to
since the spelling is uncertain.

From my review of the literature, it sounds like you may have had what’s called Lymphangioma
Circumscriptum. This lesion in an uncommon tumor of the lymph channels. It usually appears in childhood and
may suddenly enlarge later in life causing symptoms similar to what you described. However, according to my
sources, surgical removal is complicated by a high recurrence rate. Once again, I’m not sure whether you and I
are thinking about the same lesion.

In response to the second component of your question, any hormonal therapy or medication that inhibits
testosterone, will affect one’s libido and the rigidity of erections. There is a long list of medications that can
interfere with either with the production of testosterone, or with its effects on the body to reduce the chances of
developing an unwanted erection. I hope to have answered your questions and wish you the best.

This information is provided for general medical education purposes only. Please consult your physician for
diagnostic and treatment options pertaining to your specific medical condition. More individualized care is
available at the Henry Ford Hospital and its satellites (1 800 653 6568).

Sincerely,
HFHS M.D.-JJ
*Keyword: penile lesion

>>>>>>>>PATHOLOGICAL/SURGICAL REPORT

I have since obtained a copy of my chart from the urologist.
The pre and postoperative diagnosis was "lymphangiectasia with
lymphangitis of the dorsal penile shaft." The procedure performed
was an excision of said condition whereby "the lymphangiectatic
duct was isolated from the surrounding tissues and dissected free."
Further, "on the left side the structure had taken on a globular
and somewhat complex form."

The pathological report stated:
"Clinical diagnosis: lymphogenic cyst
Gross description: Received are two irregular fragments of grey-tan
soft tissue measuring 1.7 x 0.7 x 0.2 cm and 1.1 x 0.7 x 0.4 cm
in greatest dimension. Both are bisected. TS4-1
Gross and microscopic diagnosis: Thrombosed and partially
thrombosed blood vessels."

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Dear Rick,
We are glad that you could get the pathology report. Before surgery it did look like a lymphatic cyst, however pathological report clarifies that it was a thrombosed blood vessel. This condition is not very common and can occur due to several reasons including minor trauma. It is rare for it to reoccur if repeat trauma can be avoided.

This information is provided for general medical information purposes only.
Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.

The Henry Ford Hospital Department of Urology has experience in the evaluation and treatments of problems such as you describe. They would be most interested in helping you. You can reach them through our toll-free number (1-800-653-6568). We can also arrange local accommodations through this number if this is your need.
Sincerely,
HFHS M.D.-AT
*Keyword: Penile lesion
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