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Posted by JOE KELLY on July 18, 1999 at 13:32:07
I have 1 small lump on the side of my penis close to the glans, visible when erect and no pain associated with it.  I am not sexually active, my penis is not curved, I am not circumsized, nor do i take any drugs but I do drink coffee.  I am 21 years old.
I think its a clogged vein, but I am not sure.  Any suggestions/comments/cures?  I have had it for a while, maybe a couple of months.

Posted by HFHS M.D.-BE on July 22, 1999 at 12:07:53

Dear Joe kelly,
The presence of a penile lesion tends to be more disconcerting to most men than a lesion elsewhere in the body.  The primary concern is whether the lesion is cancer or not.  There are both benign and malignant lesions that may be found on the penis.  In either case no diagnosis can be made without the benefit of a physical exam and a full history.  
Given your history of no sexual activity, a sexually transmitted process can be ruled out.
Some general information about penile cancer is as follows:
The average age at diagnosis is about 60 years( ranging from 15 to 92 years).  The presenting symptoms consists of a penile mass, lump, or nodule in 47% of patients; a penile ulcer or sore in 35% of patients; ansd an inflammatory or bleeding lesion on the external surface of the penis in 17% of patients.
There are associated risk factors in the development of penile cancer.  Some are as follows: age( uncommon below age 25); circumcision( much lower rate of cancer in those circumcised, especially if done during infancy, and only a slightly higher rate if circumcised between 4 and 9 yrs. of age); race( more common in blacks than whites.  This may be a manifestation of socioeconomic or environmental factors rather than genetics); venereal diseases and hygiene( history of venereal disease in up to 22% of patients with penile cancer).  
What you have described may be a totally benign and unremrkable process, it is, however, important for you to see a urologist, especially since it has been present for only a few months.

This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its urban campuses by calling  (1 800 653 6568).
* Keyword:penile lesion
Posted by Joe Kelly on July 22, 1999 at 12:13:07
I am a 21 year old east asian male with no genealogical history of cancer in both sides of my family.  The lump does not grow and appears to be getting smaller with time, although it is still present.  Is there any way for me to rule out a clogged vein without seeing a physician?
Thanks for your time

Posted by HFHS M.D.-JS on July 29, 1999 at 11:43:27

Thank you for your inquiry.  Lesion on the penile shaft can occur from a multitude of causes.  The most important being penile cancer.  When it presents it is usually a painless ulcer or papule, sometimes with a discharge, on the glans or shaft of the penis.   Their may also be adenopathy in the inquinal region.  More common are benign conditions on the penis ranging from a sexually transmitted diseases, herpes,or condyloma to sabaceous cyst.  There are a group of pre-malignant conditions which  are also worrisome but not that common.  To help establish the diagnosis a complete history and physical exam should be performed, including a sexual history.  Laboratory studies are not as important in making the diagnosis.  Once the lesion is examined, if there is any question of possibility of malignancy a biopsy should be performed to make a histiologic diagnosis.  Once the diagnosis is made then different therapeutic options can be discussed with your physician.
It is difficult to speculate on a diagnosis without examining the lesion in person.  Someone in your age group and the  brief history you have given is more susceptible to a benign condition.  Being able to visualize the lesion with an erection also typifies a benign condition.  The superficial venous system of the penis and penile skin is often visible during erection.  There is a small possibility that one of the superficial veins have clotted but the penis has extensive collateral system and will probably not have a functional effect.  The bottom line is consult your local physician to have this lesion examined and possibly biopsied.
Sincerely, HFHS M.D.-JS
*Keyword: penis, thrombosed vein, thrombophlebitis

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