Secondary tumours of the penis

Abstract

Mr Harper and colleagues1 (January 2002 JRSM) report an unusual case of colonic adenocarcinoma presenting with a penile metastasis. We have studied the pathology of secondary neoplasms of the genitourinary tract in a series of some 27 000 necropsies at the Royal London Hospital2,3. Secondary malignancies of the penis are much less common than those of other sites in the genitourinary tract: there were 425 secondary tumours of the kidney, 155 of the bladder, 24 of the prostate, 14 of the testis, and only 5 of the penis. These 5 cases were from necropsies of men who died between the ages of 51 and 74 years. 2 were metastatic pancreatic adenocarcinomas, 2 were metastatic transitionalcell carcinomas of the bladder, and 1 a prostatic adenocarcinoma that reached the bulb of the penis by direct spread. The histological appearances were of diffuse infiltration, by tumour cells, of the vascular spaces of the corpora cavernosum and spongiosum. All had metastatic disease elsewhere. Vascular spread seems to be the usual route of metastases to the penis, though their rarity in so vascular an organ suggests that it is an unpermissive environment for tumour growth4.