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Penile Mondor disease (MD) is a palpable, painful, subcutaneous induration resulting from thrombosis of the superficial dorsal penile vein. In this report, we present a 53-year-old case of Mondor disease following prolonged, vigorous sexual activity. He had engaged in sexual activity the previous night after taking sildenafil. Physical examination revealed penile swelling and tenderness over the protruding dorsal penile vein with no evidence of penile fracture. An in-color Doppler ultrasound was promptly performed, revealing hyperechoic thrombosis in the dilated superficial dorsal penile vein accompanied by soft tissue swelling and the absence of a detectable flow signal within the thrombotic lesion. The patient was diagnosed with penile Mondor disease. The patient received conservative treatment. This case highlights the association between prolonged vigorous sexual activity, oral sildenafil uses and the development of penile Mondor disease.
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Background: Penile Mondor's disease (PMD) is a rare syndrome characterized by sclerosis after superficial thrombophlebitis of the superficial penile veins. The most usual appearance of PMD is a tender, palpable, painful, and sometimes visible cord on the dorsal surface of the penis. Its pathogenesis is still unclear, and a standardized treatment has not been established. Case report: A 54-year-old male patient presented with a left-sided indirect reducible inguinal hernia. The patient underwent Lichtenstein's procedure for inguinal hernia repair. On the tenth postoperative day, he returned with PMD confirmed by Doppler ultrasonography examination. Treatment with 4000 UI low molecular weight heparin (LMWH) daily for three weeks resolved the symptoms, but mild venous ectasia just to the proximal part of the penis remained. Discussion: The exact cause of PMD is not well understood, but various studies have identified certain factors associated with an increased risk of the condition. Out of various potential factors that could trigger PMD, the repair of an inguinal hernia has been reported only once. Treatment may involve pain management, anti-inflammatory medications, anticoagulants, and, in some cases, surgery. Conclusion: PMD after open hernia repair surgery is a very rare benign condition. Correct diagnosis and prompt treatment allowed symptom resolution. Residual venous ectasia has no clinical significance other than a cosmetic appearance.
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Background: Penile Mondor's disease (PMD) is a rare syndrome characterized by sclerosis after superficial thrombophlebitis of the superficial penile veins. The most usual appearance of PMD is a tender, palpable, painful, and sometimes visible cord on the dorsal surface of the penis. Its pathogenesis is still unclear, and a standardized treatment has not been established. Case report: A 54-year-old male patient presented with a left-sided indirect reducible inguinal hernia. The patient underwent Lichtenstein's procedure for inguinal hernia repair. On the tenth postoperative day, he returned with PMD confirmed by Doppler ultrasonography examination. Treatment with 4000 UI low molecular weight heparin (LMWH) daily for three weeks resolved the symptoms, but mild venous ectasia just to the proximal part of the penis remained. Discussion: The exact cause of PMD is not well understood, but various studies have identified certain factors associated with an increased risk of the condition. Out of various potential factors that could trigger PMD, the repair of an inguinal hernia has been reported only once. Treatment may involve pain management, anti-inflammatory medications, anticoagulants, and, in some cases, surgery. Conclusion: PMD after open hernia repair surgery is a very rare benign condition. Correct diagnosis and prompt treatment allowed symptom resolution. Residual venous ectasia has no clinical significance other than a cosmetic appearance.
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Breast pain is a common concern among women in primary care clinics. A rare cause of breast pain is Mondor's disease (MD), which can present as an acute, painful, erythematous, cord-like induration on the breast or anterior chest wall. The disorder is caused by sclerosing superficial thrombophlebitis of the anterolateral thoracoabdominal wall veins. There does not appear to be a racial or ethnic propensity for this condition; however, it is important to understand that it may be more difficult to see in darker skin types (Fitzpatrick skin types IV-VI) and requires close attention on physical exam. The cause of MD is poorly understood but may be related to direct trauma, strenuous exercise, or hormone changes. We review a case of a 54-year-old woman who presented with an anterior chest wall palpable cord, better visualized with adequate lighting and skin traction, ultimately diagnosed as MD based on clinical findings and imaging studies. Mondor's disease often resolves spontaneously with supportive care, as in this patient's case; however, clinicians should be aware of this rare cause of breast pain and its association with hypercoagulable state, vasculitis, and breast cancer.
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Neoplasias da Mama , Mastodinia , Parede Torácica , Tromboflebite , Feminino , Humanos , Pessoa de Meia-Idade , Mama , Mastodinia/etiologia , Mastodinia/complicações , Tromboflebite/diagnóstico , Tromboflebite/complicaçõesRESUMO
INTRODUCTION AND IMPORTANCE: Mondor Disease is superficial thrombophlebitis mostly located in the thoracic-abdominal wall, mid-upper arm, and penis. The disease can affect all people over 30 years old regardless of race, ethnicity but affects women more than men. The importance of this study case consists on being the first reported case of Mondor Disease in Albania. CASE PRESENTATION: In this study, a case of superficial thrombophlebitis affecting the thoraco-epigastric veins in the right chest wall is reported. Evidence of a palpable cord in the inferior outer quadrant of the breast was noted. The patient, a 49-year-old female who has been in menopause from March of 2021, presented with chest pain ought to two months of exaggerated physical activity. CLINICAL DISCUSSION: A detailed subjective and objective examination was performed. All laboratory data, including tests for COVID-19, showed normal range value except ESR. For 2 weeks under treatment with Ibuprofen, the chest pain was subsided but the palpable cord in the chest wall was persistent. CONCLUSION: Reviewing the literature and after the Color Doppler examination it has been concluded in this diagnose. It was difficult to determine the diagnosis because of no previous experience with such clinical case.
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We describe a rare case of Mondor disease of the superficial scrotal veins, which can clinically mimic acute testicular pathologies such as testicular torsion or epididymo-orchitis, and highlight the value of grayscale/Doppler ultrasound examination in distinguishing these entities, which have different management implications.
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Escroto , Humanos , Masculino , Escroto/diagnóstico por imagem , Escroto/irrigação sanguínea , Diagnóstico Diferencial , Torção do Cordão Espermático/diagnóstico por imagem , Ultrassonografia Doppler em Cores/métodos , Orquite/diagnóstico por imagem , Doença Aguda , Adulto , Veias/diagnóstico por imagem , Emergências , Ultrassonografia Doppler/métodosRESUMO
Penile Mondor's disease, or dorsal vein thrombophlebitis, is vital for urologists to recognize. It causes pain and hardening in the penis due to triggers like trauma or neoplasms. Distinguishing it from similar conditions such as sclerosing lymphangitis and Peyronie's disease is crucial. Penile Doppler ultrasound is the preferred diagnostic method. Providing reassurance can ease patient anxiety. This case report highlights a unique occurrence following forceful condom removal during sex, detailing symptoms, diagnosis, and successful treatment.
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Penile Mondor's disease is a rare condition characterized by superficial dorsal vein thrombosis of the penis, whose pathogenesis remains unclear. Prolonged or aggressive sexual intercourse has been identified as a potential risk factor. We present a case of a 54-year-old man who developed a penile mass following aggressive sexual activity. Diagnosis of superficial dorsal vein thrombosis was made using ultrasound and confirmed by MRI. The patient underwent conservative treatment and abstained from sexual activity. After four weeks, complete resolution of the thrombus was observed. This case emphasizes the importance of healthcare professionals, particularly urologists, in recognizing and managing Penile Mondor's disease.
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A 60-year-old male patient presented to the emergency department of our hospital with right-sided chest wall pain and a palpable subcutaneous cord-like structure along the right anterior chest wall. Examination revealed tenderness over the cord-like structure, and the skin overlying the structure was freely mobile and did not have any sign of infection or inflammation. Bedside ultrasonography revealed an uncompressible tubular structure with the absence of a color Doppler flow signal. The patient's presentation was suggestive of Mondor's disease. The patient was discharged with instructions to utilize anti-inflammatory drugs, perform warm compresses, and seek primary care follow-up to ensure resolution. Mondor's disease is a rare disorder characterized by a superficial thrombophlebitis of the subcutaneous veins of the chest wall. For its diagnosis, a thorough examination of the patient's medical history and physical condition is suggested; further, the performance of point-of-care ultrasonography has also been suggested. Once recognized, further emergency department workup is typically unnecessary in cases of primary Mondor's disease. Despite being a mostly self-limited condition, greater awareness of this rare disease entity is required to ensure and coordinate close outpatient follow-up as well as monitor resolution due to its association with secondary causes such as vascular and breast carcinoma, vasculitis, and hypercoagulable disorders.
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BACKGROUND: To determine the impact of Penile Mondor's disease (PMD) in patients with erectile dysfunction (ED). METHODS: Forty-seven patients diagnosed with PMD were included in the study and analyzed prospectively. The patients were divided into two groups according to the presence of ED at admission. The patients with ED were named Group 1, and those without ED were named Group 2. The International Index of Erectile Function (IIEF-5) and Beck Anxiety Inventory (BAI) forms at admission, 3rd, and 6th months were compared. RESULTS: There were 21 (44.6%) patients in Group 1 and 26 (55.4%) patients in Group 2. The mean patient ages in Group 1 and Group 2 were 38.1 ± 7.5 and 26.9 ± 10.3 years, respectively (p < 0.001). The mean admission IIEF-5 score was 19.52 ± 1.21 in Group 1 and 22.92 ± 1.23 in Group 2. After treatment, the mean IIEF-5 scores in Group 1 were 19.24 ± 1.14 and 19.09 ± 1.09 at the 3rd and 6th months, respectively. The mean IIEF-5 scores in Group 2 was 22.77 ± 0.99 and 22.96 ± 1.08 at 3rd and 6th months, respectively. In Group 1, the 6th-month IIEF-5 score was lower than the initial score (p = 0.026). In Group 1, the mean BAI score at 6 months increased compared to admission (6.0 ± 1.27 vs 5.43 ± 1.43, p = 0.015). CONCLUSION: PMD can worsen symptoms in men with ED who have a low IIEF5 score. The anxiety of recurrence of PMD during sexual intercourse may have caused this situation, or this may also be due to the natural progression of ED.
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Disfunção Erétil , Adulto , Disfunção Erétil/diagnóstico , Disfunção Erétil/epidemiologia , Disfunção Erétil/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Ereção PenianaRESUMO
On December 2020, the US Food and Drug Administration issued the first emergency use authorization for a vaccine for the prevention of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We report development of superficial thrombophlebitis in the ipsilateral breast of a 43-year-old female 7 days after receiving the first dose of the Pfizer-BioNTech COVID-19 vaccine. Given that this is the first case of superficial thrombophlebitis in the breast shortly after mRNA vaccination for COVID-19 reported to our knowledge, we suggest that this may be a rare vaccine-related event.
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BACKGROUND: Mondor disease is superficial thrombophlebitis of the thoracoabdominal wall, mid-upper arm, and penis. Although it is usually a benign disease requiring no specific treatment, little is known about this disease owing to its rarity. OBJECTIVE: The aim of this retrospective observational study was to investigate the epidemiology and prognosis of Mondor disease. METHODS: We conducted a single-center observational study of patients with Mondor disease. Patients who received a diagnosis of Mondor disease between 2015 and 2020 were analyzed. The patients' medical records were manually reviewed to obtain the following variables: date of diagnosis, patient's age, sex, department of diagnosing physicians, underlying diseases, medications, surgery, and time until resolution of the lesion. We also reviewed the 1-year mortality, 1-year occurrence of malignancy, and recurrence of Mondor disease. RESULTS: 20 patients were included in the study. The age of the patients ranged from 7 to 83 years, with a median of 47.5 years. Most of the patients presented with thoracoabdominal wall lesions. The underlying conditions included skin diseases, surgical procedures, breast cancer, smoking, and collagenous diseases, although more than half of the patients did not have plausible predisposing factors. About three-quarters of the patients saw a spontaneous resolution of the lesions within 4 weeks without medical or surgical treatments. CONCLUSIONS: Considering the good prognosis of this disease, it is essential to avoid unnecessary invasive tests or treatment once the diagnosis is confirmed.
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Neoplasias da Mama , Mastite , Tromboflebite , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tromboflebite/diagnóstico , Tromboflebite/epidemiologia , Adulto JovemRESUMO
Penile Mondor's disease (PMD), or thrombosis of the dorsal vein, is an under-reported benign condition. Its aetiology is poorly understood. Clinically, it presents as a palpable cord in the dorsal vein of the penis, with pain or local discomfort, especially during erection. PMD may be diagnosed based on the medical history and physical examination. Management of the condition is conservative, with practitioners opting for various strategies including sexual/masturbatory abstinence, localised anticoagulant topical therapy and oral nonsteroidal anti-inflammatory drugs. In many cases, PMD will resolve within 4-8 weeks of presentation. Thrombectomy and resection of the superficial penile vein are applied surgically in patients refractory to the medical treatment. We describe the case of a 33-year-old patient known to have HIV who presented for severe painful dorsal induration and swelling of the proximal third of the penis. The patient had no recent history of sexual intercourse, penile trauma or other well-known risk factors for PMD. The physical examination was unequivocal, so a Doppler ultrasound was performed. A diagnosis of PMD was made and conservative treatment was prescribed. During a follow-up visit after 6 weeks, the patient had no symptoms and physical examination did not reveal anything pathological.
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Infecções por HIV , Doenças do Pênis , Tromboflebite , Masculino , Humanos , Adulto , Tromboflebite/diagnóstico , Tromboflebite/etiologia , Tromboflebite/tratamento farmacológico , Doenças do Pênis/diagnóstico , Doenças do Pênis/etiologia , Doenças do Pênis/cirurgia , Pênis/cirurgia , Pênis/irrigação sanguínea , Anticoagulantes/uso terapêutico , Dor/etiologia , Infecções por HIV/complicaçõesRESUMO
Penile Mondor disease (MD) is a palpable, painful, subcutaneous induration caused by superficial dorsal penile vein thrombosis. We report a case of penile MD that was suspected to be related to prolonged oral sildenafil use. A 46-year-old man visited our emergency department with sustained penile pain and swelling that began 7 hours after sexual intercourse. He had used oral sildenafil intermittently for 11 years and engaged in sexual intercourse the previous night after taking sildenafil. Examination revealed no evidence of intercourse-related trauma to the genital area or an increase in penile skin temperature. However, penile swelling and tenderness over the protruding dorsal penile vein were noted. A color Doppler ultrasound examination was performed immediately, which showed hyperechoic thrombosis in the right superficial dorsal penile vein that was dilated, with soft tissue swelling and no detectable flow signal in the thrombotic lesion. The patient was diagnosed as having penile MD. The patient was treated conservatively. Some reports have indicated the involvement of sildenafil in thrombogenesis. Physicians should be aware that prolonged oral sildenafil use may be associated with penile MD.
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BACKGROUND: Mondor's disease (MD) is a rare cause of chest pain, characterized by thrombophlebitis of the subcutaneous veins of the anterolateral thoracoabdominal wall. It is a benign, self-limiting condition that is often underdiagnosed due to lack of knowledge of the condition. Although the exact aetiology is unclear, several predisposing factors, including excessive physical activity have been postulated. To the best of our knowledge, there is no previous published report of MD of the chest wall in an adult Nigerian man. OBJECTIVE: To describe the association between muscular strain and the development of MD. CASE PRESENTATION: A 40-year-old Nigerian man presented with a one-month history of dull, aching right-sided chest pain. He gave a history of engaging in intense thoracoabdominal exercises for 6 weeks prior to onset of symptoms. Physical examination revealed a tender, subcutaneous cord-like swelling extending from below the right anterior axillary fold to the right hypochondrium and accentuated by overhead abduction of the right arm. Ultrasonography revealed a hypoechoic, noncompressible right thoracoepigastric vein with no flow on Doppler interrogation, in keeping with superficial venous thrombosis. He was treated with nonsteroidal anti-inflammatory agents and paracetamol. The pain and lesion resolved completely within two weeks after presentation and there was no recurrence over the subsequent four months of follow-up. CONCLUSION: MD is an uncommon cause of chest pain that is often underdiagnosed and underreported due to lack of awareness. It can suddenly appear in persons performing extreme thoracoabdominal exercises. Treatment is essentially symptomatic. Prompt diagnosis of this self-limiting condition is essential in distinguishing it from malignant diseases.
CONTEXTE: La maladie de Mondor (MD) est une cause rare de douleur thoracique, caractérisée par une thrombophlébite des veines sous-cutanées de la paroi thoraco-abdominale antérolatérale. Il s'agit d'une maladie bénigne et spontanément résolutive qui est souvent sous-diagnostiquée en raison d'un manque de connaissance de la maladie. Bien que l'étiologie exacte ne soit pas claire, plusieurs facteurs prédisposants, y compris une activité physique excessive, ont été postulés. Au meilleur de notre connaissance, il n'y a aucun rapport publié précédemment de MD de la paroi thoracique chez un homme Nigérian adulte. OBJECTIF: Décrire l'association entre la tension musculaire et le développement de la MD. PRÉSENTATION DE CAS: Un homme Nigérian de 40 ans s'est présenté avec une histoire d'un mois de douleur thoracique sourde et douloureuse du côté droit. Il a indiqué qu'il s'était engagé dans des exercices thoraco-abdominaux intenses pendant 6 semaines avant l'apparition des symptômes. L'examen physique a révélé une tuméfaction sous-cutanée semblable à un cordon s'étendant du dessous du pli axillaire antérieur droit à l'hypochondre droit et accentuée par une abduction au-dessus du bras droit. L'échographie a révélé une veine thoraco-épigastrique droite hypoéchogène, non compressible et sans débit à l'examen Doppler, en rapport avec une thrombose veineuse superficielle. Il a été traité avec des anti-inflammatoires non stéroïdiens et du paracétamol. La douleur et la lésion ont complètement disparu dans les deux semaines suivant la présentation et il n'y a eu aucune récidive au cours des quatre mois suivants de suivi. CONCLUSION: La MD est une cause rare de douleur thoracique qui est souvent sous-diagnostiquée et sous-déclarée en raison d'un manque de sensibilisation. Il peut apparaître soudainement chez les personnes effectuant des exercices thoraco-abdominaux extrêmes. Le traitement est essentiellement symptomatique. Un diagnostic rapide de cette maladie spontanément résolutive est essentiel pour la distinguer des maladies malignes. Mots clés: maladie de Mondor, exercice, douleur thoracique, thrombophlébite.
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Parede Torácica , Tromboflebite , Adulto , Dor no Peito/complicações , Dor no Peito/etiologia , Humanos , Masculino , Nigéria , Parede Torácica/irrigação sanguínea , Parede Torácica/diagnóstico por imagem , Tromboflebite/diagnóstico por imagem , Tromboflebite/etiologia , Ultrassonografia Doppler/efeitos adversosRESUMO
Penile Mondor's disease is a rare condition characterised by superficial thrombophlebitis of the penis which is usually self-limiting. The cause is often unknown. The AstraZeneca ChAdOx1-S vaccine has been found to cause a hypercoagulable state, which is well documented. This case report describes a man who presented with Mondor's disease following ChAdOx1-S vaccination with no other risk factors. LEARNING POINTS: This is the first documented case of penile thrombophlebitis following ChAdOx1-S vaccination.We highlight a rare presentation of an uncommon condition.Clinicians should be aware of the clotting risks associated with ChAdOx1-S vaccination.
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INTRODUCTION: Penile Mondor's Disease (PMD) is a rare illness that causes thrombophlebitis in the superficial veins of the penis that is manifested by transient pain and swelling. PMD often is associated with trauma to the penis, prolonged or vigorous sexual intercourse, and has been linked to genetics. OBJECTIVES: Our aim is to review the current literature on PMD. METHODS: A comprehensive literature search of English and Turkish publications on PMD was found through PubMed and Web of Science using various keywords. It is a systematic review. RESULTS: PMD might be an uncommon, harmless condition that normalizes with moderate therapy or potentially clinical therapy. Its pathogenesis has not yet been completely explained; however, different etiological variables are known. The current studies on PMD are summarized. CONCLUSION: Analyses are frequently made with a fair history and actual assessment. In any case, education on the illness is needed. Furthermore, the identification should be supported by ultrasonography. In a greater part of the patients, results are acquired with 2 months of clinical treatment. In exceptionally uncommon cases, careful thrombectomy or expulsion of the superficial vein is required. Özkan B, Coskuner ER. What We Know About Penile Mondor's Disease. Sex Med Rev 2022;10:396-401.
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Doenças do Pênis , Tromboflebite , Coito , Humanos , Masculino , Doenças do Pênis/tratamento farmacológico , Doenças do Pênis/terapia , Pênis/irrigação sanguínea , Tromboflebite/tratamento farmacológico , Tromboflebite/terapiaRESUMO
Mondor's disease is an uncommon cause of breast and chest pain. It is characterized by cord-like thickening of the superficial veins of the anterior chest wall mimicking many life-threatening illnesses such as pulmonary thromboembolism and myocardial infarction. The disease may have been caused by trauma, other hypercoagulable states, or underlying breast diseases such as infection or carcinoma breast, but, in most cases, its etiology remains unknown. Mondor's disease is usually self-limited and can be managed conservatively. Although a rare and benign diagnosis, Mondor's disease should be a part of the differentials of chest pain, and its diagnosis can be made on the basis of a thorough clinical examination alone, which reduces not only costs but also the risks of further testing for patients presenting with chest pain. We highlight the case of a 40-year-old premenopausal female patient who presented to the outpatient department with stretching aching chest pain on the left side, which got aggravated on movements of the arm and relieved on rest. Mondor's disease is not considered a differential diagnosis for chest pain due to a lack of awareness about it. Creating awareness of this condition through this case report would help to reduce unnecessary investigations and valuable time spent and would help identify a serious underlying cause, especially early stage carcinoma of the breast.
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The thrombophlebitis of the superficial dorsal vein of the penis, called Mondor's penile disease (PMD), is a condition with a low incidence worldwide. In general, it is considered a self-limited disease that usually resolves with conservative management and very rarely requires surgical intervention. We report the case of a 41-year-old patient, who presented PMD which persists after medical treatment with nonsteroidal antiinflammatory drug and low molecular weight heparin. Surgery was decided and thrombectomy plus resection of the superficial penile vein was performed with satisfactory results. A review of the literature is presented, focusing on the limited available evidence of surgical management.