Penis & scrotum
Inflammatory
Peyronie disease


Topic Completed: 1 February 2010

Minor changes: 19 March 2020

Copyright: 2002-2020, PathologyOutlines.com, Inc.

PubMed Search: Peyronie disease[TI]

Alcides Chaux, M.D.
Alessandra F. Nascimento, M.D.
Page views in 2019: 1,062
Page views in 2020 to date: 833
Cite this page: Chaux A, Cubilla AL, Arora K, Stewart BD, Nascimento AF. Peyronie disease. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/penscrotumpeyronie.html. Accessed August 6th, 2020.
Definition / general
  • Fibrous thickening of dermis and Buck’s fascia between corpora cavernosa and tunica albuginea, causing curvature towards side of lesion and restricting movement of these structures during erection
Essential features
  • Proliferation of fibroblasts and myofibroblasts on or around the tunica albuginea of the penis, most often the dorsal aspect, that may lead to plaques with curvature of the penis towards the plaque
Terminology
  • Induratio penis plastica, penile fibromatosis
ICD coding
  • ICD-10: N48.6 - Induration penis plastica
  • ICD-11: GB06.2 - Penile fibromatosis
Epidemiology
Sites
  • Tunica albuginea, most commonly the dorsal aspect
Etiology
  • May be related to microtrauma (coital, urethral instrumentation), which releases fibroblast related cytokines
  • May arise secondary to urethritis as a sclerosing inflammatory process
  • Etiology may be related to Parc protein (BJU Int 2010;106:1706) or Wnt2 (J Sex Med 2012;9:1430)
Clinical features
  • May be associated with carcinoid syndrome, Dupuytren contracture
  • May be associated with beta blockers, thiazides (J Sex Med 2010;7:1529), hypertension, diabetes and immune reactions
  • Fibrosis produces an abnormal curvature of the penis, which may cause pain during erection and intercourse
  • In some cases, nodules adherent to tunica albuginea are noted over the mid dorsal line
  • May be clinically mimicked by epithelioid sarcoma (Int J Impot Res 2003;15:378)
Diagnosis
  • Usually clinical, however, occasionally may be a histologic confirmation
Radiology description
  • Ultrasound
    • Echogenic plaques, frequently calcifications
  • MRI
Radiology images

Images hosted on other servers:

Penile deformation

Dorsal plaque

Case reports
Treatment
Clinical images

AFIP images

Penile curvature



Images hosted on other servers:

Penile curvature

Gross description
  • Irregular areas of fibrosis in tunica albuginea with or without nodules in penile shaft
  • Occasionally nodular areas of fibrosis may predominate
Gross images

AFIP images

Tunica albuginea

Microscopic (histologic) description
  • Dense fibrous nodules, similar to those in Dupuytren contracture, fibromatosis and other desmoplastic conditions involving myofibroblasts
  • More dense and less cellular than other types of superficial fibromatosis
  • Disorganization of collagen of tunica albuginea with formation of nodules, often hyalinizing fibrosis
  • Perivascular lymphoid infiltrate in early stages of disease in 1/3
  • Fibrotic tunica albuginea with extension of fibrosis to corpus cavernosum
  • Abnormal vessels with venous leakages
  • Calcification or ossification may occur, linear band of calcification in 1/4 (J Urol 1997;157:282)
Microscopic (histologic) images

AFIP images

Thickening of tunica albuginea

Fibrosis

Positive stains
Negative stains
Electron microscopy description
  • Penile plaques are composed of collagen fibrils, amorphous particulate material and fibroblasts (Int J Urol 1997;4:274)
Molecular / cytogenetics description
Videos

Penile fibromatosis

Sample pathology report
  • Penis, plaque, excision:
    • Features consistent with Peyronie disease
Differential diagnosis
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