# Penile Calciphylaxis Obscured by Phimosis in an End-Stage Renal Disease Patient: A Case Report

## TL;DR

A rare case of penile calciphylaxis in a kidney disease patient was masked by phimosis, highlighting the need for careful diagnosis in similar cases.

## Contribution

This case report highlights calciphylaxis as a potential cause of penile pain in ESRD patients, even when phimosis is present.

## Key findings

- Penile calciphylaxis was diagnosed in an ESRD patient presenting with phimosis and penile pain.
- Histological findings confirmed calciphylaxis with suppurative inflammation.
- A partial penectomy was required due to progressive gangrene.

## Abstract

Penile calciphylaxis is a rare and severe complication primarily observed in patients with end-stage renal disease (ESRD) undergoing dialysis. A 50-year-old man presented with severe penile pain and phimosis. He had a history of hypertension and diabetes mellitus for 10 years, complicated by ESRD and was awaiting a cadaveric kidney transplant. He was on cinacalcet therapy for tertiary hyperparathyroidism. The patient underwent circumcision at which discolouration and necrotic patches involving the glans penis were noted. The histological findings were consistent with calciphylaxis and suppurative inflammation. However, due to persistent severe pain and progressive gangrene, a partial penectomy was performed. This report demonstrates the importance of consideration of calciphylaxis in patients with ESRD when presenting with penile pain, even phimosis.