{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T13:59:50Z","timestamp":1769608790441,"version":"3.49.0"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":34,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Chronic lymphatic leukemia (CLL) is the most common type of leukemia in the West, with an incidence of 4.2 per 100\u2009000 population. Penile prepuce involvement at presentation, as the first manifestation of CLL, is extremely rare. We have seen a 69-year-old male patient who presented with a non-healing ulcer on the foreskin of the penis for 6 weeks. Biopsy revealed the diagnosis of small lymphocytic lymphoma. His hematological work-up uncovered an underlying CLL. He was treated with acalabrutinib, a Bruton tyrosine kinase inhibitor, resulting in complete remission after 7\u00a0weeks. In the vast majority of patients with CLL, the disease primarily involves bone marrow, peripheral blood, lymph nodes, and spleen; extramedullary and extranodal involvement is rarely seen. This case highlights the importance of keeping leukemic involvement into consideration in patients with penile lesions, as it can be the first manifestation of underlying CLL.<\/jats:p>","DOI":"10.1093\/jscr\/rjaf1101","type":"journal-article","created":{"date-parts":[[2026,1,4]],"date-time":"2026-01-04T12:27:09Z","timestamp":1767529629000},"source":"Crossref","is-referenced-by-count":0,"title":["Leukemic penile ulcer as the presenting symptom of chronic lymphatic leukemia"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0867-5071","authenticated-orcid":false,"given":"Harsahib Singh","family":"Sandhu","sequence":"first","affiliation":[{"name":"MBBS Intern, Kasturba Medical College, Manipal, Manipal Academy of Higher Education , Tiger Circle Road, Madhav Nagar, Manipal, Karnataka, 576104 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suresh","family":"Chandra","sequence":"additional","affiliation":[{"name":"Director Histopathology, Medgenome Labs Ltd , Hosur Road, Bengaluru, Karnataka, 560100 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Smiley","family":"Joshi","sequence":"additional","affiliation":[{"name":"Consultant Medical Oncologist, Sandhu Cancer Centre , Udham Singh Nagar, Civil Lines, Ludhiana, Punjab, 141001 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,1,27]]},"reference":[{"key":"2026012712393467300_ref1","doi-asserted-by":"publisher","first-page":"rjaa549","DOI":"10.1093\/jscr\/rjaa549","article-title":"Cutaneous manifestation of leukaemia on the penis-the possible implications","volume":"2020","author":"Ng","year":"2020","journal-title":"J Surg Case Rep"},{"key":"2026012712393467300_ref2","doi-asserted-by":"publisher","first-page":"160","DOI":"10.4103\/iju.iju_424_22","article-title":"An unusual, delayed, solitary manifestation of a penile lesion in chronic lymphocytic leukemia","volume":"39","author":"Hamid","year":"2023","journal-title":"Indian J Urol"},{"key":"2026012712393467300_ref3","doi-asserted-by":"publisher","first-page":"666","DOI":"10.4103\/ijpm.ijpm_468_24","article-title":"Penile lesion as the initial presentation in chronic lymphocytic leukemia: a rare manifestation","volume":"68","author":"Kunnumbrath","year":"2025","journal-title":"Indian J Pathol Microbiol"},{"key":"2026012712393467300_ref4","doi-asserted-by":"publisher","first-page":"e2013008","DOI":"10.4084\/MJHID.2013.008","article-title":"An urologic face of chronic lymphocytic leukemia: sequential prostatic and penis localization","volume":"5","author":"D'Arena","year":"2013","journal-title":"Mediterr J Hematol Infect Dis"},{"key":"2026012712393467300_ref5","doi-asserted-by":"publisher","first-page":"e230025","DOI":"10.1148\/rg.230025","article-title":"Malignant neoplasms of the penis with radiologic and pathologic correlation","volume":"43","author":"Lubner","year":"2023","journal-title":"RadioGraphics"},{"key":"2026012712393467300_ref6","doi-asserted-by":"publisher","first-page":"9950134","DOI":"10.1155\/crh\/9950134","article-title":"Subcutaneous Leukemia cutis as the initial manifestation of CD23 negative CLL\/SLL in a patient with rheumatoid arthritis on chronic TNF-alpha inhibition","volume":"2025","author":"Ahmed","year":"2025","journal-title":"Case Rep Hematol"},{"key":"2026012712393467300_ref7","doi-asserted-by":"publisher","first-page":"2402","DOI":"10.1182\/blood.2019004492","article-title":"Prognostic and predictive impact of genetic markers in patients with CLL treated with obinutuzumab and venetoclax","volume":"135","author":"Tausch","year":"2020","journal-title":"Blood"},{"key":"2026012712393467300_ref8","doi-asserted-by":"publisher","first-page":"2497","DOI":"10.1056\/NEJMoa1109016","article-title":"SF3B1 and other novel cancer genes in chronic lymphocytic leukemia","volume":"365","author":"Wang","year":"2011","journal-title":"N Engl J Med"},{"key":"2026012712393467300_ref9","first-page":"373","article-title":"Disease progression in 150 untreated stage a and B patients as predicted by bone marrow pattern","volume":"30","author":"Pangalis","year":"1988","journal-title":"Nouv Rev Fr Hematol"},{"key":"2026012712393467300_ref10","doi-asserted-by":"publisher","first-page":"1923","DOI":"10.1182\/blood-2007-05-092882","article-title":"Relative value of ZAP-70, CD38, and immunoglobulin mutation status in predicting aggressive disease in chronic lymphocytic leukemia","volume":"112","author":"Rassenti","year":"2008","journal-title":"Blood"},{"key":"2026012712393467300_ref11","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1200\/JCO.20.00979","article-title":"Prediction of outcome in patients with chronic lymphocytic leukemia treated with ibrutinib: development and validation of a four-factor prognostic model","volume":"39","author":"Ahn","year":"2021","journal-title":"J Clin Oncol"},{"key":"2026012712393467300_ref12","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1182\/blood-2014-02-556399","article-title":"Development of a comprehensive prognostic index for patients with chronic lymphocytic leukemia","volume":"124","author":"Pflug","year":"2014","journal-title":"Blood"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/1\/rjaf1101\/66591708\/rjaf1101.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/1\/rjaf1101\/66591708\/rjaf1101.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T17:39:36Z","timestamp":1769535576000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjaf1101\/8442421"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,24]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,12,24]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjaf1101","relation":{},"ISSN":["2042-8812"],"issn-type":[{"value":"2042-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1]]},"published":{"date-parts":[[2025,12,24]]},"article-number":"rjaf1101"}}