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Case Reports
. 2024 Aug 18;16(8):e67156.
doi: 10.7759/cureus.67156. eCollection 2024 Aug.

Penile Calciphylaxis Obscured by Phimosis in an End-Stage Renal Disease Patient: A Case Report

Chathurangi U Angammana  1 , Hilary Fernando  2 , Fhds Silva  1
Affiliations
Case Reports

Penile Calciphylaxis Obscured by Phimosis in an End-Stage Renal Disease Patient: A Case Report

Chathurangi U Angammana et al. Cureus. .

Abstract

Penile calciphylaxis is a rare and severe complication primarily observed in patients with end-stage renal disease (ESRD) undergoing dialysis. A 50-year-old man presented with severe penile pain and phimosis. He had a history of hypertension and diabetes mellitus for 10 years, complicated by ESRD and was awaiting a cadaveric kidney transplant. He was on cinacalcet therapy for tertiary hyperparathyroidism. The patient underwent circumcision at which discolouration and necrotic patches involving the glans penis were noted. The histological findings were consistent with calciphylaxis and suppurative inflammation. However, due to persistent severe pain and progressive gangrene, a partial penectomy was performed. This report demonstrates the importance of consideration of calciphylaxis in patients with ESRD when presenting with penile pain, even phimosis.

Keywords: end stage renal disease (esrd); hemodialysis; partial penectomy; penile calciphylaxis; phimosis.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Discolouration of the glans penis at the time of circumcision suggestive of calciphylaxis
Figure 2
Figure 2. Photomicrographs (A: Right side, B: Left side) of excision biopsy of glans penis with haematoxylin and eosin stain, showing extensive suppuration, tissue necrosis, with focal calcification
Figure 3
Figure 3. Subsequent calciphylaxis developing in the third finger resulting in gangrene
See this image and copyright information in PMC

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