Spontaneous resolution of penile sclerosing lymphangitis with conservative management: a case report and literature review

Background: Penile sclerosing lymphangitis is a rare, benign condition characterized by chronic inflammation and sclerosis of the penile lymphatic vessels. Due to its rarity and non-specific presentation, it is often underdiagnosed and misdiagnosed as other penile pathologies. Case: We report a case of a 39-year-old male who presented with an incidental, firm, cord-like structure along the dorsal penile shaft. The patient denied pain, discomfort, or erectile dysfunction and had no history of trauma or sexually transmitted infections. Physical examination and penile ultrasonography confirmed the diagnosis of penile sclerosing lymphangitis. The patient reduced the frequency of sexual activity or masturbation to once a week. At the 6-month follow-up, the lesion had completely resolved without pharmacological intervention. Conclusions: Penile sclerosing lymphangitis is a self-limiting condition that can resolve with conservative management and lifestyle modification. Increased awareness and accurate diagnosis are essential to avoid unnecessary interventions.

Penile sclerosing lymphangitis; Lymphatic sclerosis; Penile cord; Differential diagnosis; Conservative management

[1] Hutchins P, Dunlop EMC, Rodin P. Benign transient lymphangiectasis (sclerosing lymphangitis) of the penis. The British Journal of Venereal Diseases. 1977; 53: 379–385.

[2] Rosen T, Hwong H. Sclerosing lymphangitis of the penis. Journal of the American Academy of Dermatology. 2003; 49: 916–918.

[3] Alrubaiaan MT, Alotaibi M, Alekrish KA. Non-venereal sclerosing lymphangitis of the penis in a 35-year-old Saudi male: a case report. Cureus. 2022; 14: e31087.

[4] Karray M, Litaiem N, Jones M, Zeglaoui F. Sclerosing lymphangitis of the penis associated with marked penile oedema and skin erosions. BMJ Case Reports. 2017; 2017: bcr2017221414.

[5] Tamraz H, Kibbi AG, Abbas O. Firm cord-like band over the penile shaft. International Journal of Dermatology. 2012; 51: 29–30.

[6] Öztürk H. Penile Mondor’s disease. Basic and Clinical Andrology. 2014; 24: 5.

[7] Kumar B, Narang T, Radotra BD, Gupta S. Mondor’s disease of penis: a forgotten disease. Sexually Transmitted Infections. 2005; 81: 480–482.

[8] Selvaraj R, Sivakumar A, Saravanan K. Penile Mondor’s disease co-occurring with sclerosing lymphangitis: a double whammy. Indian Journal of Sexually Transmitted Diseases and AIDS. 2024; 45: 91–92.

[9] Foresti M, Parmiggiani A. Penile Mondor’s disease: imaging in two cases. Radiology Case Reports. 2020; 14: 24–30.

[10] Amano M, Shimizu T. Mondor’s disease: a review of the literature. Internal Medicine. 2018; 57: 2607–2612.

[11] Rodríguez Collar TL. Lymphangitis sclerosing of the penis: case presentation. Revista Habanera de Ciencias Médicas. 2014; 13: 701–707. (In Spanish)

[12] Babu AK, Krishnan P, Andezuth DD. Sclerosing lymphangitis of the penis—literature review and report of 2 cases. Dermatology Online Journal. 2014; 20: 13030/qt7gq9h1v9.

[13] Briken P, Bőthe B, Carvalho J, Coleman E, Giraldi A, Kraus SW, et al. Assessment and treatment of compulsive sexual behavior disorder: a sexual medicine perspective. Sexual Medicine Reviews. 2024; 12: 355–370.