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.