Case Report Open Access Persec et al., J Clin Exp Dermatol Res 2013, S6 DOI: 10.4172/2155-9554.S6-011 J Clin Exp Dermatol Res Dermatology: Case Reports ISSN: 2155-9554 JCEDR, an open access journal Keywords: Median raphe cyst; Immunohistochemical analysis; Surgical treatment Summary Cysts of the median raphe are very rare. We describe a 20-year-old man with an asymptomatic nodule on the ventral surface of the penis. Te nodule was surgically removed under local anesthesia, and send to histological and immunohistochemical analysis. Immunohistologicaly epithelial cells appeared Cytokeratin-7 (CK7), epithelial membrane antigen (EMA) positive and anti-S100 protein (S100), Cytokeratin-20 (CK20), smooth muscle actin (SMA) and carcinoembryonic antigen (CEA) negative. Histological and immunohystochemical fndings indicate median raphe cyst. Introduction Median raphe cysts of the penis are benign lesions in young men [1,2]. Median raphe cyst was frst described in detail by Mermet in 1895 [1,2]. Tese cysts are midline-developmental and can occur anywhere from the anus to the urinary meatus [1,2]. When located on the border of the meatus they are also termed as parameatal cysts [3]. Lesion is usually asymptomatic, but can be complicated by infection or trauma [2,4]. It is thought that cysts of the median raphe to arise from embryologic developmental defects of the male urethra [1-3]. Histologically the cyst does not communicate with the urethra and is lined by a pseudostratifed, columnar or stratifed squamous cell epithelium, similar to urethral transitional epithelium [2,5]. Te luminal cells may present with minimal secretion [6,7]. Terefore the lesion can be misinterpreted as an apocrine hydrocystoma or cystadenoma [6,7]. Case Report We present a 20-year old man with an asymptomatic nodule on the ventral surface of the penis. Physical examination revealed round, painless, sof nodule, 0.9 cm in diameter on the ventral surface of the penis, just proximal to the glans (Figure 1). Tere was no history of trauma or infection. In this case, because of problems during sexual intercourse was treated surgically this change on the penis. Histolopathological examination showed unilocular cystic cavity within the corium, lined by columnar, partially pseudostratifed epithelium with occasional mucinous cells (Figure 2). Te lumen was empty. Tere was no epithelial atypia or infammatory infltrate. *Corresponding author: Zlatko Hrgovic, Department of Gynecology, University Hospital Osijek, Croatia, Europe, Tel: 0049 69 293000; Fax: 0049 69 291697; E-mail: info@hrgovic.de Received December 26, 2012; Accepted February 26, 2013; Published March 09, 2013 Citation: Persec Z, Persec J, Sovic T, Rako D, Bacalja J, et al. (2013) Median Raphe Cyst–Clinical Report and Immunohistochemical Analysis. J Clin Exp Dermatol Res S6: 011. doi:10.4172/2155-9554.S6-011 Copyright: © 2013 Persec Z, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Median Raphe Cyst–Clinical Report and Immunohistochemical Analysis Zoran Persec 1 , Jasminka Persec 2 , Tomislav Sovic 1 , Duje Rako 2 , Jasna Bacalja 3 , Zlatko Hrgovic 4 * and Roland Kaufmann 5 1 Department of Urology, University Hospital Dubrava, Zagreb, Croatia 2 Anesthesiology, Reanimatology and Intensive Care Medicine Clinic, University Hospital Dubrava, Zagreb, Croatia 3 Department of Pathology, University Hospital Dubrava, Zagreb, Croatia 4 Department of Gynecology and Obstetrics, J.-W Goethe University School of Medicine, Frankfurt/M, Germany 5 Department of Dermatology and Venereology, J.-W Goethe University School of Medicine, Frankfurt, Germany Immunohistologicaly epithelial cells appeared EMA (Figure 3a) and CK7 (Figure 3b) positive and S100, CK20, SMA i CEA negative. Histological and immunohystochemical fndings indicate median raphe cyst. Discussion Median raphe cysts of the penis are benign and very rare lesion [1,2]. Only a few cases have been published, mostly in dermatology journals rather than urology publications. Te cysts are usually asymptomatic; hence, many cases are probably not reported. Numerous terms including mucus cyst of the penis, genitoperineal cyst of the medium raphe, parameatal cyst, hydrocystoma, and apocrine cystadenoma of the penile shaf have been proposed to describe the lesion and should be regarded as synonymous [3]. Median raphe cyst is considered an embryologic developmental Abstract Cysts of the median raphe are very rare. We describe a 20-year-old man with an asymptomatic nodule on the ventral surface of the penis. The nodule was surgically removed under local anaesthesia, and send to histological and immunohistochemical analisys. Immunohistologicaly epithelial cells apeared Cytokeratin-7 (CK7), Epithelial membrane antigen (EMA) positive and anti-S100 protein (S100), Cytokeratin-20 (CK20), smooth muscle actin (SMA) and carcinoembryonic antigen (CEA) negative. Hystological and immunohystochemical fndings indicate median raphe cyst. Figure 1: Ventral surface of the penis, just proximal to the glans. Journal of Clinical & Experimental Dermatology Research J o u r n a l o f C l i n i c a l & E x p e r i m e n t a l D e r m a t o l o g y R e s e a r c h ISSN: 2155-9554