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April 2006

A Reddish Nodule on the Glans Penis—Diagnosis

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Arch Dermatol. 2006;142(4):515-520. doi:10.1001/archderm.142.4.515-d

Hematoxylin-eosin–stained sections of the biopsy specimen showed a dense cellular neoplasm occupying the dermis, with a slight upward extension of the cells in the epidermis. Atypical melanocytes with large hyperchromatic nuclei were seen, often arranged in nests along the basal cell layer. The infiltrating tumor was composed of epithelioid or spindle cells and reached the outer portion of the corpus cavernosum. Some mitotic figures were present.

The diagnosis of melanoma, 3.04 mm in Breslow thickness, Clark level III, was made. The patient was referred to the urology department for a total amputation of the penis and an ilioinguinal lymphadenectomy. Sentinel lymphoscintigraphy was not performed because our case was observed and treated in 1991, when this technique was not yet in use. Three years later, the patient died of widespread metastatic disease.