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Monckeberg's calciphylaxis with necrosis of the glans penis: A case presentation
Author(s) -
SORENSEN Mathew D.,
LONG Layron O.,
WESSELLS Hunter,
KUAN James K.
Publication year - 2007
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1542-4758.2007.00183.x
Subject(s) - medicine , penectomy , calciphylaxis , surgery , glans , penis , urethrostomy , gangrene , glans penis , corpus spongiosum , end stage renal disease , hemodialysis , penile cancer , disease
Abstract Monckeberg's calcific sclerosis of the media of the small‐sized and medium‐sized arteries is a well described and potentially life‐threatening condition seen almost exclusively in patients with end‐stage renal disease (ESRD) and with hyperparathyroidism. Penile gangrene resulting from this entity is associated with a mortality as high as 64%. A 65‐year‐old man with ESRD on dialysis for 6 years was referred to Harborview Medical Center with severe penile pain and partial necrosis of his glans penis, which progressed despite medical management. The patient had previously undergone amputations on all four extremities. After intraoperative biopsies of the proximal corpora cavernosa and spongiosum demonstrated viable tissue, he underwent partial penectomy. Pathologic evaluation revealed calciphylaxis within the media of the penile vessels. Two months later the patient had persistent wound‐healing issues with intractable pain and thus underwent a complete penectomy with ultimate resolution of his severe pain.