Penile self-amputation

Excerpt

A 75-year-old widower with a history of depression was admitted because of an 8-week history of genital bleeding. He lived alone; he had no history of major medical or surgical conditions, and was being treated with antidepressants since his wife died about 5 years earlier. The physical examination revealed the absence of penis with minimal bleeding from the penile stump (Fig. 1). Three years earlier, the patient had noticed the occurence of an ulcerative lesion at the root of the penis, which had widened and had led to a spontaneous amputation of the organ. Due to shame, he had not revealed this event even to his doctor. A total body computed tomography showed pathological lymph nodes in the groin and extensive hepatic metastases. The patient underwent biopsy of the penile ulcer and the histological examination confirmed the diagnosis of a spinocellular epithelioma.

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