Multifocal penile epithelioid angiomatous nodule: A rare tumor of penis

Abstract

Epithelioid angiomatous nodule (EAN) is a rare benign vascular lesion that was first reported in 2004. This article presents the case of a 29-year-old male with multiple focal EANs on his penis, a highly uncommon location for this condition. The patient had been experiencing painful nodules for 6 months, initially misdiagnosed as hemangioma and later as epithelioid hemangioendothelioma. Physical examination revealed bluish, well-circumscribed lesions on the corona and glans penis. Microscopic evaluation of an incisional biopsy confirmed the diagnosis of a penile EAN. EAN falls within the spectrum of epithelioid vascular tumors, but it is considered a newly described acquired vascular proliferation. It typically presents as small, fast-growing nodules on the extremities and trunk, though it can also occur on the face and mucosal surfaces. While most cases are solitary, conglomerated multiple nodules may also be seen. The condition predominantly affects adults between 15 and 45 years old. Differential diagnoses for EAN include epithelioid hemangioma, epithelioid angiosarcoma, and bacillary angiomatosis. EAN is clinically benign but can significantly impact the patient's quality of life, especially when located on sensitive areas like the penis. Simple local excision is a curative method, though reconstructive procedures may be necessary in some cases. Due to the limited number of cases reported in the literature, the pathogenesis and possible causes of EAN remain unclear. Further research and increased study of this condition are needed to gain a better understanding of its nature and potential etiology. Accurate diagnosis is crucial to distinguish EAN from other malignant vascular pathologies and prevent unnecessary interventions.