Contents lists available at ScienceDirect Urology Case Reports journal homepage: www.elsevier.com/locate/eucr Inflammation and infection Epidermoid cyst on frenulum of the penis: A case report Pande Made Wisnu Tirtayasa a,* , Nyoman Dwi Aussie Hary Mastika b a Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Udayana/Sanglah Hospital, Bali, Indonesia b Department of Surgery, Bhakti Rahayu Hospital, Bali, Indonesia ARTICLE INFO Keywords: Epidermoid cyst Penis Penile ABSTRACT Epidermoid cyst in the penis is uncommon and only a small number of cases have been reported. We presented a thirty-two-year-old male patient with a case of slow growing, mobilized, non-tender frenulum of the penis mass that developed in 10 years period. Surgery treatment was taken under local anesthesia. Pathological examination was revealed as epidermoid cyst. Care must be given during examination of these lesions to rule out another entity. If there is any indication, complete excision is the best treatment as another treatment may lead to the risk of recurrence. Introduction Epidermoid cysts are the most common cutaneous cysts and may develop from any parts of the human body. However, epidermoid cyst in the penis is uncommon and only a small number of cases have been reported. These lesions generally do not show any symptoms and the cause of these lesions is unknown but may arise from either acquired or congenital. 1 We presented a case of a slow growing penile epidermoid cyst located on frenulum of the penis that developed in 10 years period. From our knowledge, this is the first documented case of penile epi- dermoid cyst from Indonesia. Case presentation A 32-year-old man came to the surgery clinic with a ten-year symptom of a slow-growing penile nodule. A mobile, elastic and pain- less mass was found on the right ventral of frenulum of the penis (Fig. 1). The medical history including urinary tract infection, dysuria, hematuria, trauma was otherwise unremarkable. Further thorough physical examination was normal except for the penile nodule. Blood examination for liver and kidney function was otherwise normal, as well as urinalysis and urine culture. Penile ultrasound revealed the existence of well-defined cystic appearance around 3 cm in diameter. Moreover, the cyst was showed to be separated from the erectile tissue as well as urethra. Complete excision of the cyst was performed under regional anesthesia and was continued with circumcision under pa- Fig. 1. Clinical appearance of penile epidermoid cyst in the frenulum of the penis (A & B). https://doi.org/10.1016/j.eucr.2018.08.021 Received 27 July 2018; Accepted 22 August 2018 * Corresponding author. Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Udayana/Sanglah Hospital, Jl. Kesehatan No.1 Denpasar, Bali, 80114, Indonesia. E-mail addresses: wisnu.tirtayasa@gmail.com, wisnu_tirtayasa@unud.ac.id (P.M.W. Tirtayasa). Urology Case Reports 21 (2018) 56–57 Available online 04 September 2018 2214-4420/ © 2018 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/). T