Primary Penile Leiomyosarcoma

A large, asymptomatic nodule developed on the head of the penis of a 68-year-old man who was otherwise in good health. The patient had palpable, but painless, bilateral inguinal adenopathy.

Key point: The most common tumor of the penis is a squamous cell carcinoma. However, other neoplasms can occur in this area: melanoma, sarcoma, and (rarely) basal cell carcinoma and cutaneous metastasis (typically from bladder cancer). A biopsy revealed primary penile leiomyosarcoma. Lymph node biopsy only showed reactive hyperplasia.

Treatment: Conservative surgical excision was performed, followed by radiotherapy.

Note: The treatment of genital sarcoma is determined by the type of tumor, not by the localization to genital skin. Genital sarcoma is more common on the vulva than on the penis, making this a rare case.