Answer for CoW 18 June 2017
Superficial dorsal penile vein thrombosis (Penile Mondor's disease)
Findings
Cord is the thrombosed dorsal vein which is thickened and adherent to the overlying skin. The lesion can extend superiorly into the infrapubic area.
Discussion
Penile Mondor's disease Superficial thrombophlebitis of the penis Males in the 21-70 years age range. Direct and indirect trauma are known as causative factors, such as excessive sexual activity (most consistent predisponding factor), prolonged sexual abstinence, local or distant infectious processes, venous obstruction secondary to bladder distension, pelvic tumors or constrictive elements used in certain sexual practices, and the abuse of certain intravenous drugs. There have been reports of associations with certain tumors (of the bladder and prostate gland), and the condition has also been described as an unusual initial manifestation of disseminated pancreatic adenocarcinoma. Patients usually present a ropelike cord on the dorsum of the penis. The cord is the thrombosed dorsal vein, which has become thickened and adherent to the overlying skin. Symptoms typically last from 6 to 8 weeks and resolve completely, although have been described some cases with recurrences. Ultrasound study of the penis with Doppler must support the diagnosis, especially in cases where the diagnosis is not very evident and in the follow up of these patients to visualize resolution of the thrombus and restoration of normal blood flow after treatment. It is also useful in the differential diagnosis including ruptured corpus cavernosum, Peryronie's disease and sclerosing lymphoedema. Ultrasound findings are more relevant to non-compressibility or absence of flow within the superficial dorsal vein of the penis. Sometimes the ultrasound observes the presence of a clot intravascular. Several methods of treating superficial thrombophlebitis of the dorsal vein of the penis have been proposed. NSAID, and occasionally topical heparinizing agents are used.
Findings
Cord is the thrombosed dorsal vein which is thickened and adherent to the overlying skin. The lesion can extend superiorly into the infrapubic area.
Discussion
Penile Mondor's disease Superficial thrombophlebitis of the penis Males in the 21-70 years age range. Direct and indirect trauma are known as causative factors, such as excessive sexual activity (most consistent predisponding factor), prolonged sexual abstinence, local or distant infectious processes, venous obstruction secondary to bladder distension, pelvic tumors or constrictive elements used in certain sexual practices, and the abuse of certain intravenous drugs. There have been reports of associations with certain tumors (of the bladder and prostate gland), and the condition has also been described as an unusual initial manifestation of disseminated pancreatic adenocarcinoma. Patients usually present a ropelike cord on the dorsum of the penis. The cord is the thrombosed dorsal vein, which has become thickened and adherent to the overlying skin. Symptoms typically last from 6 to 8 weeks and resolve completely, although have been described some cases with recurrences. Ultrasound study of the penis with Doppler must support the diagnosis, especially in cases where the diagnosis is not very evident and in the follow up of these patients to visualize resolution of the thrombus and restoration of normal blood flow after treatment. It is also useful in the differential diagnosis including ruptured corpus cavernosum, Peryronie's disease and sclerosing lymphoedema. Ultrasound findings are more relevant to non-compressibility or absence of flow within the superficial dorsal vein of the penis. Sometimes the ultrasound observes the presence of a clot intravascular. Several methods of treating superficial thrombophlebitis of the dorsal vein of the penis have been proposed. NSAID, and occasionally topical heparinizing agents are used.
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
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Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!