A rare presentation of hidradenocarcinoma within the penis

Penile carcinoma is a rare malignancy representing 1% of male cancers. Squamous cell carcinoma accounts for 95% of all penile cancers.1 Cutaneous adnexal tumours can be benign or malignant lesions and tend to present on the head, neck and extremities. Cutaneous adnexal tumours of the penis are extremely rare and have only been reported once in the literature.2 To our knowledge, metastatic spread from these tumours on the penis has never been reported before. We present a case of a malignant cutaneous adnexal tumour of the penis with progressive metastatic spread. Case presentation A 46-year-old man presented with a cystic mass on the shaft of his penis. He had no significant co-morbidities. On examination, there was a mobile nodule over the left side of the distal shaft of the penis, proximal to the coronal sulcus near the frenulum, measuring 8mm in diameter. There was no palpable groin lymphadenopathy. He underwent a wide local excision of the lesion. Histological examination revealed a multi-nodular, solid-cystic and poorly differentiated carcinoma located within the dermis, measuring 15mm by 10mm with a margin of less than 5mm. On closer evaluation, the tumour resembled a high-grade and malignant cutaneous adnexal tumour of hidradenocarcinoma sub-type. It was characterised by large lobulated islands of basaloid cells, an abundance of mitotic figures and multiple foci of necrosis. Lymphovascular invasion was present but perineal invasion was not (Fig. 1, Fig. 2). Open in a separate window Fig. 1 HE (b) primary lesion seen on high power view; (c) primary lesion demonstratin lymphovascular invasion; (d) recurrent lesion presenting with corpora cavernosa.