Transitional cell carcinoma presenting as clitoral priapism

Background. Clitoral priapism is an uncommon cause of clitoromegaly. It should be suspected in the absence of hirsuitism and the presence of clitoral engorgement, pain, and local irritation. Case. A 48-year-old female had a straight catheterization of her bladder for a history of frequent urinary tract infections. She was noted to have a clitoral size of 5 x 2.5 cm along with the classic findings of priapism. She had an 8 x 10 cm pelvic mass that was biopsied and revealed transitional cell carcinoma with papillary squamous component. Conclusion. Clitoral priapism presents with clitoral engorgement in the absence of sexual stimulation. The most common etiologies include medications, pelvic tumors, blood dyscrasias, or retroperitoneal fibrosis. A thorough investigation is warranted to identify potential pelvic venous or lymphatic obstruction. (C) 2004 Elsevier Inc. All rights reserved.