Penile Pseudomyogenic Hemangioendothelioma: Diagnostic and Therapeutic Considerations

Pseudomyogenic hemangioendothelioma (PHE) is a rare vascular tumor of low-grade malignancy, most commonly affecting the limbs of young males. Its occurrence in the penis is extremely uncommon. We present a case of a 19-year-old male with a one-year history of a painful penile mass. Imaging and histopathology confirmed the diagnosis of PHE localized to the right corpus cavernosum, with partial involvement of the left side. Preoperative planning included MRI with pharmacologically induced erection and 3D modeling. Reconstructive organ-sparing surgery was performed, involving excision of the midportion of the right corpora cavernosa and partial excision of the left, followed by reconstruction using a bovine pericardial graft. At the six-month follow-up, no recurrence of the disease was observed on PET-CT, and the patient exhibited preserved urinary and erectile function, with moderate right-sided curvature. A minor revision procedure was required due to graft infection. This report highlights the diagnostic and therapeutic challenges associated with penile PHE. A multidisciplinary approach incorporating advanced imaging and 3D modeling can facilitate function-preserving surgery with satisfactory short-term outcomes.