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Magnetic resonance imaging of penile rhabdomyosarcoma

George S. Ganesan, MD David Cory, MD ^* Michael E. Mitchell, MD and Jeffrey A. Jones, MD

Department of Urology, Division of Pediatric Urology, ZC-10 University of Washington Medical Center, 1959 N.E. Pacific Street, Seattle, WA 98195 ^* Department of Urology, Division of Pediatric Urology, ZC-10 University of Washington Medical Center, 51373 Pebble Beach Court, Granger, IN 46530 Department of Urology, James Whitcomb Riley Hospital For Children, 702 Barnhill Drive, Indianapolis, IN 46202, USA

This excerpt was created in the absence of an abstract.

In recent years the management of sarcomas of the penis has undergone a radical change. The trend of treatment has shifted away from mutilating surgery (Ashley & Edwards, 1957; Pratt & Ross, 1969), which often left the phallus functionally inadequate and the patient a psychological cripple, to one of conservation of the penis, in selected patients. Adjuvant chemotherapy and excision of the tumour with preservation of the penis has been shown to hold promising results in two patients (Pak etal, 1986; Dalkin & Zaontz, 1989). This has been made possible, largely because of improved chemotherapy of sarcomas in general (Hays etal, 1982a & b).

Magnetic resonance (MR) imaging has been reported previously to be of value in the evaluation of penile pathology, such as Peyronie's disease, carcinoma of the urethra and metastases to the penis (Hricak et al, 1980; Hricak et al, 1988). This report illustrates the use of MR imaging in the staging and follow-up of a soft tissue sarcoma of the penis. This is the first reported case of the successful treatment of an infiltrating sarcoma of the penis, by chemotherapy alone. Evaluation of the response to chemotherapy is dependent on accurate and sensitive imaging modalities. MR imaging seems to fill this role admirably.

A 3-year-old white male presented with a mass, of 4 months duration, on the dorsum of his penis. The child was otherwise asymptomatic. Physical examination revealed a hard mass extending from the corona to the base and circumscribing the penis.

Key Words: Penile tumour • Rhabdomyosarcoma • Imaging • Magnetic resonance

Received for publication March 20, 1991. Revision received July 25, 1991. Accepted for publication September 16, 1991.