Rarely a hematologic malignancy can result in a penile ulcer after infiltrating the skin.
Hematologic malignancies that may infiltrate the skin of the penis and cause an ulceration include:
(1) chronic lymphocytic leukemia
(2) acute leukemia (leukemia cutis)
(3) Waldenstrom's macroglobulinemia
(4) malignant lymphoma
The diagnosis may be considered if there is a history of the hematological malignancy, but it may be more challenging if it is the presenting complaint.
Inguinal lymphadenopathy may or may not be present.
The diagnosis typically requires a biopsy with appropriate immunostains for hematologic markers.
The diagnosis also requires exclusion of alternative diagnosis, include pseudolymphoma.
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