Buerger Disease of the Penis

초록

Buerger disease is a non-arteriosclerotic, segmental, progressive, inflammatory vaso-occlusive disease of unknown etology. It mainly involves the tibial and radial arteries and sometimes secondarily extending to veins and nerves of the extremities. It occurs almost exclusively in susceptible men who are heavy smokers. Tabacco extracts may induce direct endothelial cell toxicity or hypersensitivity. Recently we have experienced a case of Buerger disease of the glans penis. There was no previous report of Buerger disease of this site in the English literature. A 46-year-old man was admitted with a 2-month history of ulceration in the glans penis and secondary infection. He has smoked one pack of cigarettes daily for 29 years. Buerger disease was diagnosed 4 years ago when he developed migratory thrombophelebitis, followed by ischemic manifestations involving left 4th finger, requiring amputation. At that time, the extremity arteriography revealed right 4th palmar metacarpal artery was not observed and digital branch showed irregular contour. During 4 years, the patient condition was relatively good until this February. To evaluate the ulceration of glans penis, biopsy was done. The microscopic examination showed surface ulceration with dense lymphoplasma cell infiltration in the dermis. The vessels showed obliteration with organizing thrombus formation and recanalization. Many vascular wall was destructed due to vasculitis.