Partial segmental thrombosis of the corpus cavernosum

Case contributed by Dr Chris O'Donnell

Presentation

Sudden painful lump in the base of the penis on the right after sexual intercourse, without priapism

Patient Data

Age: 42
Gender: Male
MRI

Urgent US (not available) had revealed an intracavernous mass without blood flow ? neuroma. MRI for clarification

Well-defined mass in the proximal right corpus cavernosum.  Note mass is bright on T1 = methaemoglobin with minor peripheral enhancement.  Swollen right corpus caused extrinsic compression to the left

Case Discussion

Partial thrombosis of the corpus is rare and often well-defined (as in this case) due to the segmental nature of the corpus whereby there appears to be a septum dividing it into proximal and distal portions (proximal always seems to be involved).  Microtrauma (at intercourse) is believed to be responsible for the development of thrombus.  Treatment is expectant and usually successful with spontaneous resolution.  MRI is helpful for diagnosis (as in this case) due to the presence of T1 hyperintensity = methaemoglobin and absence of enhancement as might occur in a solid mass lesion.

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Case information

rID: 42830
Case created: 10th Feb 2016
Last edited: 6th Jun 2017
System: Urogenital
Inclusion in quiz mode: Included

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