RESUMO
OBJECTIVE: Tuberculosis of the penis is an extremely rare disease with few cases reported in the literature. METHOD: We present the case of a 64 year-old man with a whitish papular-ampullary eruption in the glans penis. After antibiotic/antimycotic therapy and several topical ointments for 3 months without response he was referred to our Department. Biopsy of the ulceration edge was performed and pathology result showed a chronic granulomatous inflammatory necrotizing lesion with granulomatous vasculitis lesions, without tumor infiltration. Systemic examination to rule out other tuberculosis foci was negative. With de suspicion of primary tuberculosis of the glans penis, anti tuberculosis therapy with Isoniazid and Piridoxine was started. RESULTS: Within a period of five months the ulceration healed significantly. Currently, the patient is still asymptomatic without glans penis lesions. CONCLUSIONS: Primary glans penis tuberculosis is a rare disease, but we must consider it (both primary and secondary forms) to try to avoid diagnostic delays that may cause prejudice for the patient. This condition promptly responds to anti tuberculosis therapy as evidenced by our case and many other reports.
Assuntos
Doenças do Pênis/tratamento farmacológico , Pênis/patologia , Tuberculose/tratamento farmacológico , Antituberculosos/uso terapêutico , Humanos , Isoniazida/uso terapêutico , Masculino , Pessoa de Meia-Idade , Doenças do Pênis/etiologia , Doenças do Pênis/patologia , Piridoxina/uso terapêutico , Resultado do Tratamento , Tuberculose/complicações , Tuberculose/patologiaRESUMO
Malakoplakia is a uncommon chronic granulomatous condition of a benign nature preferentially occurring in the genitourinary tract. Testes are affected in 12% of cases, and the first case of testicular malakoplakia was reported in 1958. Forty cases have been reported worldwide since that date. We report a new case of testicular and epididymal malakoplakia in a 68-year-old male patient diagnosed of complicated orchiepididymitis who underwent orchidectomy to rule out a malignant tumor. The histopathological study demonstrated a chronic inflammatory infiltrate with histiocytes with an eosinophilic cytoplasm containing the characteristic Michaelis-Gutmann bodies diagnostic of malakoplakia. In connection with this new case and because of its unusual presentation, the literature on testicular malakoplakia is reviewed.
Assuntos
Malacoplasia , Doenças do Pênis , Idoso , Humanos , Malacoplasia/diagnóstico , Malacoplasia/cirurgia , Masculino , Doenças do Pênis/diagnóstico , Doenças do Pênis/cirurgiaAssuntos
Cornos , Bexiga Urinária/lesões , Bexiga Urinária/patologia , Ferimentos não Penetrantes/patologia , Animais , Antibacterianos/uso terapêutico , Infecções Bacterianas/prevenção & controle , Bovinos , Fístula/patologia , Humanos , Masculino , Tomografia Computadorizada por Raios X , Cateterismo Urinário , Adulto JovemRESUMO
OBJETIVOS: Aportar un nuevo caso de tuberculosis primaria de pene dada su infrecuente incidencia, con pocos casos descritos en la literatura. MÉTODO: Presentamos el caso de un varón de 64 años de edad, sin antecedentes urológicos de interés, que acude a consulta de dermatología por aparición de lesión ampollosa blanquecina en glande de tres meses de evolución que no mejora con antibióticos-antimicóticos tópicos (Médico de Atención Primaria). Se realiza biopsia de glande con resultado anatomopatológico de inflamación granulomatosa necrotizante con lesiones de vasculis granulomatosa, sin infiltración tumoral. Tras descartar posibles focos tuberculosis a nivel sistémico comienza tratamiento con Isoniazida más Piridoxina. RESULTADOS: A los cinco meses de evolución el paciente presenta gran mejoría clínica, con disminución de la lesión peneana y asintomático desde el punto de vista urológico. CONCLUSIONES: La tuberculosis primaria de pene es una patología infrecuente aunque debemos tenerla en mente (tanto formas primarias como secundarias), para así intentar evitar el retraso diagnóstico con el consecuente perjuicio para el paciente. El inicio de una terapia antituberculosa muestra respuestas favorables en la mayoría de los casos de forma relativamente precoz
OBJECTIVE: Tuberculosis of the penis is an extremely rare disease with few cases reported in the literature. CLINICAL CASE: We present the case of a 64 year-old man with a whitish papular-ampullary eruption in the glans penis. After antibiotic/antimycotic therapy and several topical ointments for 3 months without response he was referred to our Department. Biopsy of the ulceration edge was performed and pathology result showed a chronic granulomatous inflammatory necrotizing lesion with granulomatous vasculitis lesions, without tumor infiltration. Systemic examination to rule out other tuberculosis foci was negative. With de suspicion of primary tuberculosis of the glans penis, anti tuberculosis therapy with Isoniazid and Piridoxine was started. RESULTS: Within a period of five months the ulceration healed significantly. Currently, the patient is still asymptomatic without glans penis lesions. CONCLUSIONS: Primary glans penis tuberculosis is a rare disease, but we must consider it (both primary and secondary forms) to try to avoid diagnostic delays that may cause prejudice for the patient. This condition promptly responds to anti tuberculosis therapy as evidenced by our case and many other reports
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Tuberculose dos Genitais Masculinos/diagnóstico , Dermatopatias Vesiculobolhosas/diagnóstico , Diagnóstico Diferencial , Doenças do Pênis/tratamento farmacológico , Antituberculosos/uso terapêuticoRESUMO
La malacoplaquia es un proceso granulomatoso crónico de naturaleza benigna, poco frecuente, que afecta de forma preferente al tracto genitourinario. El compromiso testicular representa el 12%; se ha descrito el primer caso de malacoplaquia a este nivel en 1958. Desde entonces, 40 casos se han publicado en todo el mundo. Presentamos un nuevo caso de malacoplaquia testicular y epididimaria en un varón de 68 años diagnosticado de orquiepididimitis complicada, al que se le practicó orquiectomía con el fin de descartar proceso neoformativo maligno. El estudio histológico objetivó la presencia de un infiltrado inflamatorio crónico con histiocitos de citoplasma eosinófilo, en el interior de los cuales se visualizaron los característicos cuerpos de Michaelis-Gutmann, que dieron el diagnóstico de malacoplaquia. A propósito de este nuevo caso, y por lo inusual de su presentación, realizamos una revisión de la literatura científica de la entidad que nos ocupa (AU)
Malakoplakia is a uncommon chronic granulomatous condition of a benign nature preferentially occurring in the genitourinary tract. Testes are affected in 12% of cases, and the first case of testicular malakoplakia was reported in 1958. Forty cases have been reported worldwide since that date. We report a new case of testicular and epididymal malakoplakia in a 68-year-old male patient diagnosed of complicated orchiepididymitis who underwent orchidectomy to rule out a malignant tumor. The histopathological study demonstrated achronic inflammatory infiltrate with histiocytes with an eosinophilic cytoplasm containing the characteristic Michaelis-Gutmann bodies diagnostic of malakoplakia. In connection with this new case and because of its unusual presentation, the literature on testicular malakoplakia is reviewed (AU)