Surgical excision of perineal nodular induration: A cyclist’s third testicle

Authors

  • Mohannad A. Awad University of California, San Francisco
  • Gregory P. Murphy University of California, San Francisco
  • Thomas W. Gaither University of California, San Francisco
  • E. Charles Osterberg University of Texas - Dell Medical School, Austin
  • Thomas A. Sanford University of California, San Francisco
  • Andrew E. Horvai University of California, San Francisco
  • Benjamin N. Breyer University of California, San Francisco

DOI:

https://doi.org/10.5489/cuaj.4169

Abstract

Perineal nodular induration (PNI), or biker’s nodule, is a rare, bothersome, pseudotumour. Herein, we describe the surgical technique used to treat a healthy cyclist who developed an enlarging PNI for five years that grew into a perineal mass. The mass prevented him from cycling due to worsening discomfort and heaviness. The PNI-associated mass was successfully removed by wide surgical excision and a local advancement flap. Subsequently, the patient resumed cycling. Histopathology report demonstrated a benign lesion with abundant ropy collagen with native smooth muscle, vessels, and rare fibroblast-like spindle cells. With the increasing popularity of cycling, PNI may become more common, and health providers should be aware of this rare entity and how it can be safely removed.

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Author Biography

Mohannad A. Awad, University of California, San Francisco

Master's in Clinical Research Student, applying for residency this year

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Published

2017-05-09

How to Cite

Awad, M. A., Murphy, G. P., Gaither, T. W., Osterberg, E. C., Sanford, T. A., Horvai, A. E., & Breyer, B. N. (2017). Surgical excision of perineal nodular induration: A cyclist’s third testicle. Canadian Urological Association Journal, 11(5), E244–7. https://doi.org/10.5489/cuaj.4169

Issue

Section

Techniques in urology