Tancho nodules (Lipogranulomatous lesions) of the Penis: A Review and Update

The practice of implanting glass or other kinds of beads in the subcutaneous tissue of the penis for the purpose of increasing the sexual pleasure of the partner has become common. The inserted glass beads have tended usually not to give rise to symptoms and normally they are only detected by chance. Lipogranuloma of penis which is also known as paraffinoma, sclerosing lipogranuloma, and Tancho nodules, may affect the penile or scrotal skin. Penile lipogranuloma is usually been known to be due to hypodermic injection of substances such as paraffin, silicone, oil, or wax into the penis for enlargement of the penis or sexual gratification. Within the scrotum, trauma, cold weather, and topical application of ointment do at times give rise to chronic inflammatory lesions within the penis that is suggesting of percutaneous absorption, which has also have been implicated in the development of Lipogranuloma of penis or Tancho nodules. Additionally, utilization of liquid paraffin instillation in to the urethra followed by urethral dilatation procedure has also been reported to have caused inflammatory nodules within the penis. Most lipogranulomas arise in men younger than 40 years who report a localized plaque or mass that may be tender and indurated, and as large as several centimetres in diameter. They may also present with some or any of the following: a nodule or nodules in the penis; a papule or plaque on the penis; a rash around a penile injection site; an ulceration or ulcerations on the penis; an abscess within the penis; sepsis following which a nodule or lesions is/are found in the penis; pulmonary embolism; pain and swelling within the penis extending into the scrotum; pain and swelling in the penis and groin; pain and swelling in the inguinal region mimicking lymph adenitis or an inguinal hernia; lower urinary tract voiding symptoms and on rarer-occasions the development of urinary retention; infertility; loss of sexual satisfaction; expression of discomfort by sexual partner during coital activity; experiencing of pain by the man within his penis during coital activity; bleeding from a penile lump during coital activity; curvature of the non-erect penis or curvature of the erect penis associated with coital penile discomfort. Biopsy of the penile lesion for pathology examination is necessary to confirm the diagnosis, especially in the absence of clinical history of injection of exogenous material into the penis.