Presentation
Penile and scrotal pain and swelling for 1 week. Prostate cancer.
Patient Data
Irregular fluid collections with fine internal septations and rim enhancement within the corpora cavernosa of the penis, more prominent on the right side where there is extension posteriorly to the level of the inferior pubic ramus. The collections were present but much smaller on the prior CT, and were not present on the more remote CT from November 2021. Small symmetric fluid collections at the inferior aspect of the prostate gland bilaterally, stable since November. Prostate gland brachytherapy implants. No scrotal subcutaneous fluid collection. Subcutaneous thickening along the inferior aspects of the hemiscrotum is bilaterally is unchanged, of doubtful clinical significance. No soft tissue gas. Urinary bladder is decompressed by a suprapubic catheter, otherwise unremarkable.
Small areas of irregular mixed lytic/sclerotic change in the inferior pubic rami bilaterally, more marked on the left side than the right, unchanged.
IMPRESSION:
Enlarging fluid collections in the corpora cavernosa of the penis, suspicious for abscess formation.
Patient seen by urology. 50 cc frank pus aspirated from right corpus cavernosum. C&S yielded Streptococcus anginosus.
Case Discussion
Abscess of the corpus cavernosum is a rare entity. Potential sources of infection include hematogenous spread, intracavernosal injection, and penile prostheses. There may be underlying immunosuppression.
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