Pediatric Surgery, Al Azher University, Cairo, Egypt
Penile hemangioma is a very rare benign vascular neoplasm, mostly seen in children and young adults with different features.
KeywordsHaemangiomasStrawberry nevusKlippel-Trenaunay syndromeKasabach-Merritt syndromeTissue expanderAngiokeratoma of Fordyce
Generally haemangiomas are the most common pediatric neoplasm, occur in about 10 % of all births, and usually appear between 1 and 4 weeks after birth, but penile hemangioma comprises less than 1 % of all hemangiomas. Capillary hemangioma is the most common variant of hemangioma, it occurs 5 times more often in female infants than in males, and mostly in Caucasian populations. The incidence of capillary hemangioma in the penis and scrotum is rare, which presented with scrotal enlargement and tenderness, only a few number of articles describing scrotal hemangioma have been reported .
A capillary hemangioma also known as an Infantile hemangioma, Strawberry hemangioma, and Strawberry nevus.
Haemangiomas are benign vascular lesions resulting from abnormal proliferation of blood vessels, capillary hemangioma appears as a raised, red, lumpy area of flesh anywhere on the body, without any known etiology (Fig. 17.1).
Capillary haemangioma of the penis, with glanular affection
Hemangiomas are generally classified into capillary, cavernous, arteriovenous, venous and mixed subtypes and may be composed of vessels whose walls are abnormal and cannot be identified as arterial or venous (Figs. 17.2 and 17.3). Complex vascular malformation of the penile skin may give a false picture of penile gigantism or megalopenis (Chap. 10).
Mixed arteriovenous malformation affecting the skin of the penis, prepuce and scrotum
Mixed vascular malformation of the penis with a superficial capillary heamnagioma
Penoscrotal area may be affected along the vascular syndromes like; Kasabach-Merritt syndrome which is a rare type of vascular lesion with peculiar characteristics based upon three basic findings; enlarging haemangioma, thrombocytopenia and consumption coagulopathy . Klippel-Trenaunay syndrome (KTS) is another syndrome with genital affection, it was first described in 1900 by two French physicians, Klippel and Trenaunay. It is a rare congenital syndrome of venous, lymphatic, and capillary malformations (port-wine stain and varicose veins) with soft tissue and bone hypertrophy. Patients can be diagnosed with KTS with only one or more of the above-mentioned features since patient might not have all the features . Scrotum usually affected along the course of the diseases, and rarely the lesion may be extended to the penile shaft or the prepuce (Figs. 17.4 and 17.5).
Kasabach-Merritt syndrome affecting the right lower limb