Title : Calciphylaxis associated penile gangrene masquerading as penile Cancer: A Case Report
Abstract:
60-year-old African American male with a complex medical history, including obesity, diabetes, dyslipidemia, coronary artery disease, hypertension, and end-stage renal disease on hemodialysis, presented in June 2023 with lumbar pain and dysuria. Physical examination revealed severe penile edema, phimosis, and darkened, necrotic glans and foreskin. CT imaging showed bilateral hydronephrosis, thickening of the urinary bladder wall, extensive atherosclerotic calcification, and enlarged inguinal lymph nodes. An MRI identified a large mass in the glans and foreskin. Initial treatment included the insertion of a suprapubic catheter to address obstructive uropathy and antibiotic therapy. Despite this, the patient’s condition worsened, necessitating surgical intervention. A penile biopsy ruled out cancer, and necrosis and gangrene were confirmed during surgery. A partial penectomy was performed, which involved the removal of necrotic tissue and reconstruction of the penile stump. Postoperative examination of the excised tissue showed necrotic glans with calcified vessels and fibrosed intima, consistent with the clinical findings. The patient recovered well, with satisfactory wound healing and discharge on the 10th postoperative day.
