International Clinical and Medical Case Reports Journal (ISSN: 2832-5788) | Volume 5, Issue 7 | Case Report | Open Access
Ashwini Kadam*
Department of Urology, Yashoda Superspeciality Hospital, Somajiguda, Hyderabad, India
*Correspondence to: Ashwini Kadam
Fulltext PDFBackground: Primary penile malignancies account for less than 1% of all male genitourinary cancers, with non-epithelial mesenchymal neoplasms comprising fewer than 5% of these cases. Among primary penile sarcomas, undifferentiated pleomorphic sarcoma (UPS)—previously categorized as malignant fibrous histiocytoma (MFH)-represents an exceedingly rare, aggressive histological subtype with limited published data to guide standardized management.
Case Presentation: A 59-year-old African male presented with a 6-month history of a painless, progressively enlarging nodular mass on the penile shaft. Physical examination revealed a 7 × 6 cm, non-ulcerated, firm mass fixed to the underlying corpora cavernosa without palpable inguinal lymphadenopathy. Core needle biopsy demonstrated a high-grade spindle cell neoplasm with 10–12 mitoses per high-power field (HPF). Positron emission tomography–computed tomography (PET-CT) demonstrated a hypermetabolic, locally infiltrative penile mass involving the bilateral corpora cavernosa and corpus spongiosum, regional bilateral inguinal lymphadenopathy, and a suspicious lesion in the right adrenal gland. The patient underwent total penectomy with perineal urethrostomy. Histopathological and immunohistochemical (IHC) profiling confirmed the diagnosis of primary undifferentiated pleomorphic sarcoma (vimentin-positive; Pan-CK, S100, CD34, CD21, HMB-45, and SOX10 negative). The patient subsequently completed six cycles of palliative systemic chemotherapy with doxorubicin and ifosfamide before being lost to follow-up.
Conclusions: Primary UPS of the penis is an aggressive diagnostic entity that requires prompt histological confirmation and immunohistochemical exclusion of sarcomatoid carcinoma, melanoma, and specific soft tissue sarcomas. Radical surgical resection with negative margins remains the cornerstone of local disease control, whereas multimodal systemic therapy is indicated for advanced or metastatic disease.
Undifferentiated Pleomorphic Sarcoma; Malignant Fibrous Histiocytoma; Penile Sarcoma; Penectomy; Immunohistochemistry; Case Report.
Ashwini Kadam. Primary Undifferentiated Pleomorphic Sarcoma of the Penis: A Case Report and Comprehensive Literature Review. Int Clinc Med Case Rep Jour. 2026;5(8):1-7.