Penile ossification: A traumatic event or evolutionary throwback? Case report and review of the literature
Pathologic calcification or ossification refers to the process by which calcium salts build up in soft tissue, causing it to harden and form extraskeletal bone. This may result from a malignant infiltrative process, hypercalcemia secondary to a paraneoplastic syndrome, end stage renal disease, calcium-phosphate abnormalities caused by hyperparathyroidism or other metabolic derangements, or from a local metaplastic process resulting from repeated trauma or a chronic inflammatory state.
Ossification occurring in the human penis is exceedingly rare, with fewer than 40 cases reported. Another related condition, “congenital human os penis,” is also extremely rare, with only 1 reported case in a 5-year-old boy. Ossification of the penis is most commonly due to Peyronie’s disease, a chronic inflammation of tunica albuginea that leads to penile fibrosis. The hardened plaque reduces flexibility and leads to a penile bend or curvature during erection. Less common etiologies of penile ossification have been reported, including local trauma to the penis, chronic hemodialysis in patients with end-stage renal disease, chronic inflammatory states as in syphilis and gonorrhea, and with general metabolic disorders such as gout and diabetes. ...
The earliest case of penile ossification in the literature was reported by McClellan in 1827, who described a case of ossification along the full length of penis. In 1899 Chetwood reported a second case of ossification of corpora cavernosa in a postmortem specimen of a 55-year-old diabetic man. In 1933, Vermooten described a 19-year-old male in whom a bony mass had developed in the glans penis. The patient also had a gunshot wound at that site 3 months previously. Presumably ossification had taken place in fibrosis resulting from this injury. A fourth case of penile ossification was reported by Eglitis in 1953. In this case, microscopic examination of sections taken from a grossly normal penis at autopsy identified bony plaques in the subcutaneous tissue, with no clues as to the etiology of this ossification. In 1962, Elliot and Fischerman reported a case of a 68-year-old man who presented with a 5-cm bone in his corpus spongiosum which required surgical excision. The man was previously diagnosed with gout; however, the bone formation was thought to be unrelated. Subsequent to these rare cases of penile ossification reported in the early literature, other cases of localized penile ossification secondary to Peyronie’s disease have been reported.
As the condition is so rare, controversy remains as to the etiology of penile ossification. Some have pointed to a possible connection between human penile ossification and the normally occurring os penis in animals. ...
