Multiple Penile Schwannomas

Wayne Young Liu, MD; Chao-Hsiang Chang, MD; Gaun-Chin Tseng, MD

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In This Article

Discussion

Most schwannomas are benign. Only 4 malignant penile schwannomas have been reported in the literature; 3 of them were associated with Recklinghausen's disease. No cases of benign penile schwannoma have been reported to be associated with hereditary diseases.[1]

If the schwannoma is at or near the glans penis, it may interfere with sexual intercourse. Surgical excision of the tumor is indicated if the tumor induces dyspareunia. There is no strong evidence about the relationship between schwannoma and erectile dysfunction.[2,3,4] Our patient's erectile dysfunction (preoperative IIEF = 14) worsened postoperatively (IIEF = 0); however, because there were no surgical complications, such as numbness, tenderness, or scarring on the penile shaft, it is difficult to say whether his penile schwannoma was a major or minor factor in his erectile dysfunction. Therefore, the underlying causes of erectile dysfunction in this patient should be evaluated further.

The differential diagnosis of superficial tumor in the penis should include lipoma, atheroma, fibroma, Peyronie's disease, fibrosis from autoinjection, and schwannoma.[5] In the literature, most penile schwannomas are located at the dorsum of the penis in the Buck's fascia, which is not characteristic of Peyronie's disease or injection-related fibrosis.[5,6] Lipoma and atheroma can be differentiated from penile schwannoma because the former are softer and more superficial. In addition to excision biopsy of the tumor, imaging studies, such as ultrasonography and magnetic resonance imaging, can be informative diagnostic modalities.

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