Epithelioid Hemangioma of the Glans Penis in a Preschool-Aged Child: A Case Report

Background: Epithelioid hemangioma is an uncommon benign vascular tumor, and involvement of the glans penis is exceptional in childhood. Case Presentation: We report the case of a 4-year-old boy who presented with a longstanding, painless, pedunculated pink nodule on the dorsal glans adjacent to the urethral meatus. Previous topical treatment for presumed balanitis relieved pruritus but did not modify the lesion. Complete local excision was performed under general anesthesia with local infiltration, with preservation of the urethral structures. Histopathological examination showed a well-circumscribed polypoid mucosal lesion with epithelioid endothelial proliferation, small vascular channels, and mild stromal inflammation, without cytological atypia. Immunohistochemistry showed strong FLI-1 and CD34 positivity, supporting endothelial differentiation; CD31 was not performed. The morphological features strongly favored benign epithelioid vascular proliferation and were not consistent with epithelioid hemangioendothelioma or epithelioid angiosarcoma. The postoperative course was uneventful, and follow-up at 12 months showed no recurrence. Conclusions: This case illustrates the need to consider rare vascular tumors in persistent pediatric penile lesions. A treatment-refractory glanular lesion in a child should prompt early histopathological assessment rather than prolonged empirical therapy.