ISSN 0391-5603 Urologia ( 2017 ; 00 ): 000=000 00 © 2017 Wichtg Publishing UJ CASE REPORT Case descripton A 53-year-old Caucasian man was admited in the Uro- logical Department for an erectle dysfuncton associated with perineal pain. The patent complained of an erectle dysfuncton, perineal pain, and discomfort in sitng posi- ton and during defecaton. The physical examinaton, in- cluding rectal examinaton, resulted negatve. Ultrasound assessment of perineum revealed a large, solid mass in the urogenital triangle, localized between the lef cavernous body and the bulbar spongy urethra, with a maximum di- ameter of 26 mm. Magnetc resonance imaging (MRI) fnd- ings confrmed the presence of a large nodular mass before transverse perineal muscle, hyperintense on T2 image and hypointense on T1 image (Fig. 1). Ultrasound-needle biopsy was performed and the pathological examinaton revealed a histological patern compatble with a diagnosis of benign schwannoma. The immunohistochemistry profle was both negatve for desmin and smooth muscle actn but positve for S100 and Kit67. The patent underwent a complete exci- sion of the tumor. Surgery started with an arciform incision on the lef of the perineal area. Using metculous dissec- ton, the mass was separated completely from the lef cav- ernous body and spongy urethra. Macroscopic features of the mass were an ovoid white-yellowish mass, with limited areas of hemorrhage. Histopathological examinaton con- frmed a benign Schwannoma: bifasic patern of palisaded cells (Antoni A) with Verocay bodies associated with myxoid component (Antoni B) (Fig. 2). Afer the surgery, at the frst follow-up, the patent had no discomfort during defecaton, but he stll complained of pain and erectle dysfuncton, DOI: 10.5301/uj.5000247 Perineal schwannoma: an unusual tumor and clinical presentaton – frst case with erectle dysfuncton associated with this neoplasm Filippo Cecconi 1 , Giuseppe Maiolino 1 , Federico Lanzi 1 , Gianni Vitori 1 , Filippo Gentle 1 , Gerardo Pizzirusso 1 , Gabriele Barbant 1 , Sergio Tripodi 2 1 Azienda Ospedaliera Universitaria Senese, U.O.C. Urology, Siena - Italy 2 Azienda Ospedaliera Universitaria Senese, U.O.C. Pathological Anatomy, Siena - Italy Introducton Perineal schwannomas are very rare benign tumors that arise from Schwann cells of the peripheral nerve sheath placed in perineal area. Schwannomas are typical of young male patients aged 20-50 years, located in the head and neck area and flexor surface of the extremities (1). They usually grow slowly and show a nonaggressive bi- ological behavior in both local and systemic sets, excluding the cases of compression of the surrounding structures. They represent the 5% of all benign soft tissue tumors, but their perineal location is rare and only few cases are reported in the literature. None of these describes erec- tile dysfunction among the symptoms. Here, we report a case of an unusual clinical presentation as compared with the other reported in literature and we provide its clinical, radiological, and pathological features. In addi- tion, we report a useful table in which we have collected important information from previous reports available in literature. ABSTRACT Introducton: Perineal schwannomas (PS) are very rare benign tumors with few cases reported in literature and none of these reports erectle dysfuncton among clinical presentatons. Case descripton: We report a case of PS with unusual clinical presentaton showing erectle dysfuncton as- sociated with perineal pain and discomfort during defecaton, and the postoperatve residual pain and erectle dysfuncton treatment. Conclusions: On the basis of a literature review of all cases reported and on our case reported, we have delin- eated a clinical, diagnostc, and therapeutc profle of PS, summarized in a useful table. Keywords: Erectle dysfuncton, Perineum, Schwannoma, Tumor Accepted: May 1, 2017 Published online: June 26, 2017 Corresponding author: Filippo Cecconi, MD Strada Delle Scote, 14 53100 Siena, Italy Silfl2004@tscali.it