Content area
Full Text
Background
It is a rare presentation of common disease. Pilonidal sinus is usually found in the natal cleft (sacrococcygeal region) and this is an unusual site for presentation.
Case presentation
A 19-year-old fit Caucasian man who is slim and not hairy, presented to our urology outpatient clinic with a long-standing swelling at the distal penile shaft for more than a year. The patient was not circumcised. The swelling occasionally gets inflamed and increases in size with discharge to a small opening beneath the foreskin at the coronal sulcus. On examination, a smooth round mobile subcutaneous swelling could be easily felt at the distal shaft of the penis. The foreskin was normally retractable to reveal the swelling projecting beneath the foreskin with a small sinus at the coronal sinus ( figure 1 ).
Differential diagnosis
A differential diagnosis for any penile mass in this region will generally come under the following categories: Benign non-cutaneous lesions : retention cysts, congenital/acquired inclusion cysts, syringomas and neurilemomas.
Benign tumours of the supporting structures : angioma, fibroma, neuroma,...