Epithelioid hemangioma of the penis. A rare and distinctive vascular lesion

Two patients, aged 36 and 47 years, respectively, had indurated subcutaneous penile nodules that were treated by local excision. Histologically, the lesions were characterized by cords and nests of plump epithelioid cells separated by a loose stroma containing numerous lymphocytes and eosinophils. Light microscopy identified definite vasoformative areas and solid regions with cytoplasmic vacuolization and nuclear atypia. Ultrastructural studies and immunohistochemical analysis for factor VIII-related antigen and Ulex europaeus agglutinin I demonstrated that the lesions were of endothelial origin. After excision of the nodules, the two patients are free of disease 5 1/2 and 6 1/2 years later, respectively. To our knowledge, a review of the literature produced only one similar case. These unusual vascular lesions, of undetermined cause, are proliferations of endothelial cells exhibiting an epithelioid structure that should be considered benign and treated locally.