Elevated plasma factor VIII coagulant activity presenting with thrombophlebitis of the deep dorsal vein of the penis.

A 55-year-old man started to suffer from severe penile pain 2 days after engaging in sexual intercourse in the woman-on-top position. A fixed, 2-cm long, cord-like lesion was found on the dorsal midline of his penis which was in a partially tumescent state. Ultrasonography showed part of the deep dorsal vein was obstructed by a hyperechoic mass. Laboratory tests revealed elevated plasma factor VIII coagulant activity. The patient received thrombophlebectomy of the deep dorsal penile vein. Pathology reported venous thrombosis with eosinophilic and lymphocytic infiltration of the venous wall. At the outpatient follow up, painful thrombophlebitic veins at the previous i.v. accesses were noted on his left arm. He has received long-term warfarin control as suggested by hematologists. This patient represents the first reported case of deep dorsal penile thrombophlebitis associated with elevated plasma factor VIII coagulant activity, which is an independent risk factor of recurrent venous thromboembolism and superficial thrombophlebitis.