Penile Metastasis Research Articles

The first case of penile metastases of adrenocortical cancer: A clinical case

Metastases of malignant neoplasms into the penis from various primary locations are extremely rare. These lesions are due to the disseminated tumor. In most cases, the primary tumors are located in the genitourinary system (75%), gastrointestinal tract (21%), and lungs (7%). The prognosis is poor, with most patients dying within a year of diagnosis. The purpose of the article is to present a rare case of metastatic lesion of the penis in adrenocortical cancer. A 59-year-old patient with a stage III right adrenal tumor pT3N0M0 had undergone an adrenalectomy. Histological and immunohistochemical studies showed the classic version of adrenocortical cancer with Ki-67 40%. Mitotane with polychemotherapy according to the EP-M scheme was administered for the adjuvant purpose. In 3 months, the patient developed induration and local soreness in the root of the penis. Magnetic resonance imaging of the pelvic organs showed a hypodense zone in the cavernous bodies. Combined positron-emission and X-ray computed tomography with 18-fluorodeoxyglucose showed a mass in the left cavernous body with increased radiopharmaceutical uptake. Specific lesions were found in the mediastinal and retroperitoneal lymph nodes, liver, bed of the removed tumor, and soft tissues of the lumbar region. Tumor generalization with multiple synchronous metastases, including the penis, was established. Cytological examination of the punctate showed malignant cells. Palliative polychemotherapy was administered according to the EDP-M regimen with glucocorticoids. The treatment had no effect. The patient died 7 months after the establishment of penile metastasis. This case of a penile metastatic lesion in a patient with primary adrenocortical cancer is presented for the first time in the available literature. The main symptoms of the disease are the presence of a tumor in the area of the root of the penis and local pain. Magnetic resonance imaging and combined positron emission and X-ray computed tomography with 18-fluorodeoxyglucose are methods of choice for medical imaging that reliably determine the tumor extension. The location of the primary tumor outside the pelvis in a patient with penile metastases is usually accompanied by multiple synchronous metastases involving other organs.

Penile metastasis of prostate cancer imitating Peyronie's disease detected on [68Ga]Ga-PSMA-11 PET/CT

Penile metastasis of prostate cancer imitating Peyronie's disease detected on [68Ga]Ga-PSMA-11 PET/CT

The Factors Predicting the Incidence of Regional Lymph Node Metastases in Patients with Penile Cancer Patients at Prof Dr. I.G.N.G. Ngoerah Hospital Denpasar

Background: Penile cancer is a rare but potentially fatal malignancy, the cause of which is not fully understood. The incidence in Bali shows that from April 1993 to May 2005, there were 72 cases of penile cancer. Penile cancer lymph node metastasis influences the choice of surgical therapy and is also a strong predictor of prognosis. Proper diagnosis and treatment, especially regarding inguinal lymph node metastasis, will affect the prognosis in penile cancer patients. Objective: This study aims to prove the existing factors are predictors of the incidence of regional lymph node metastases in penile cancer patients. Methods: This study used a retrospective analysis design, with a cohort design to prove the location of the primary tumor, primary tumor size, clinical lymph node palpation, preoperative lymphocyte monocyte ratio (LMR), and tumor histopathological subtype as predictor factors of regional LNM in penile cancer patients. A total of 98 patients and predictor factors were analyzed based on OR and RR values from bivariate and multivariate tests. Results: Primary tumor location on the gland and prepuce, positive inguinal lymph node clinical palpation are predictors of LNM incidence in penile cancer patients. While primary tumor size, preoperative LMR value, and histopathological subtype were not associated. Conclusion: Many factors are associated with regional LNM in penile cancer which is associated with poor clinical outcomes. The most influential factors are the location of the primary tumor and clinical palpation of inguinal lymph nodes which can be considered as a nomogram to risk stratify patients and determine eligibility for inguinal lymphadenectomy.

A Secondary Urothelial Carcinoma of the Penis Diagnosed

Aim: Penile cancer is one of the rarest urogenital cancers. Penile metastases after cystectomy are possible and seem to be associated with the existence of an extensive tumor on the surgical specimen. Case Presentation: We report here the case of old man 78 years old, with a history of Radical Cysto-Prostatectomy with Bricker type urinary diversion, indicated for a pT3N0M0R0 infiltrating urothelial carcinoma of the bladder. He had consulted 7 years post surgery for an indurated lesion of the penis with urethrorrhagia. On examination, he presented an ulcerative-necrotic lesion under the left lateral coronal area of the penis, a diffuse induration of corporal bodies from the glans to the bulb, bilateral inguinal macro lymphadenopathies. Magnetic Resonance Imaging of the penis suggested a tumor extending over the entire penis, infiltrating the corpora cavernosa and spongiosa, with invasion of the albuginea, adjacent fat and skin. In view of this picture, a total penectomy with emasculation was performed. The histology of the surgical specimen showed a poorly differentiated urothelial carcinoma with an immunohistochemical study in favor of a primary urothelial origin (GATA3+). The tumor infiltrated both corpora cavernosa and the urethra with positive margins of resection. The right inguinal lymph node dissection showed one metastatic node out of two. The left inguinal lymph node dissection showed one metastatic lymph node out of six with capsular rupture. Thoracic-abdominopelvic CT Scan showed a right inguinal adenopathy with no other lesions suggestive of secondary localization. The diagnosis of secondary urothelial carcinoma of the penis classified as pT4N2M0R1 was made and the patient underwent chemotherapy on tumor board meeting. Conclusion: Secondary cancers of the penis, although rare, can occur years after radical treatment of the primary tumor. Immuno-histochemestry was esential to differentiate from primary squamous cell carcinoma in our case.

(019) Malignant Priapism: Case Report and Update on Management Protocols

(019) Malignant Priapism: Case Report and Update on Management Protocols

Kidney cancer metastases to breast and other genitourinary (GU) organs: A pooled analysis.

401 Background: As the number of kidney cancer survivors increases, the appearance of second malignancies and unusual metastatic patterns is increasing. We performed a pooled analysis to assess the clinicopathologic findings, treatment, and outcomes of cases involving breast and GU organs. Methods: Pooled analysis of published case reports and case series of renal cell carcinoma (RCC) metastasis to breast and genitourinary (GU) organs, including four cases from our institution. Parameters were compared between GU organ cohorts using a one-way ANOVA test and subgroup analysis. Results: 127 patients with GU metastasis of RCC were analyzed. The overall mean age was 61.2 years (Range: 14-92). GU organs with reported metastasis included 24 to testis (18.9%), 18 to penis (14.2%), 18 to breast (14.2%), 17 to vagina (13.4%), 17 to bladder (13.4%), 14 to ovary (11%), 7 to prostate (5.5%), and 6 to urethra (4.7%). Median Fuhrman grade was 2.5 overall, with penis metastases (n=4) having a median grade of 4. 95 of 111 (86%) cases reported patients with GU metastasis that had a prior nephrectomy for RCC. Patients with breast metastasis (n=16) had a significantly longer time between nephrectomy and metastatic diagnosis (90.1±63.1 months) than penile (12.7±16.1 months, n=6, p<0.01), bladder (28.7±26.6 months, n=15, p<0.01), or vaginal cohorts (6.7±5.2 months, n=3, p<0.05). Co-metastasis to extra-GU sites were most prevalent in penile metastasis (47.4%, n=9). The primary treatments for metastases were excisional surgery (79%), immunotherapy (18%), radiotherapy (14%), and tyrosine kinase inhibitors (13%). The breast cohort (n=10) reported a 90% survival rate at final follow-up, while the vaginal (n=8) and penile (n=12) cohorts reported survival rates of 50%. The urethra cohort (n=2) had a median survival time of 53 months, while the breast cohort (n=10) had a median survival time of 6 months. Conclusions: While kidney cancer's metastasis to other GU organs is relatively uncommon, it presents unique diagnostic and therapeutic challenges. Recognizing these patterns and understanding the biology behind such spread can offer insights into RCC's behavior and drive more effective treatments. [Table: see text]

Penile Metastasis From Esophageal Squamous Cell Cancer

Penile Metastasis From Esophageal Squamous Cell Cancer

International case series of metastasis to penis.

To evaluate clinical characteristics associated with survival in patients with metastases to the penis. After approval by the IRB, records of collaborating centres in Leuven, London, Rostock, Amsterdam and Tampa were screened for men presenting with metastatic disease to penis. Multivariate logistic regression analyses were used to identify covariables associated with survival. We analysed clinical data on 34 patients. Primary sites were most frequently prostate (n= 14, 41%) and bladder (n= 9, 26%). Twenty-eight of 34 (82%) presented with metachronous penile metastases, and 11 (32%) patients had penile metastases as the sole metastatic site. Penile metastatic locations were most frequently in the corpora (n= 18; 53%). Seven (21%) patients with penile metastases had priapism on presentation. Systemic therapy was frequent and variable (chemotherapy n= 12; immunotherapy n= 5; hormones n= 3). Local management included either surgery (n= 10) or RT (n= 8). Twelve- and 24-month overall survival rate were 67% and 35%, respectively. No clinical parameter including primary histology, synchronous or metachronous metastases or priapism showed statistical survival benefit or detriment. Metastasis to penis arises most frequently from pelvic primaries. Priapism does not appear to correlate with survival in this large, well-defined series.

Penile Metastasis of Colorectal Cancer: Case Report and Discussion on this Rare Clinical Entity

We report a rare case of penile metachronous metastasis of mesorectal adenocarcinoma in an asymptomatic patient, who initially only accepted chemotherapy, but after thirty months underwent total penectomy followed by radiotherapy, due to penile pain caused by ingravescent metastasis. After another cycle of chemotherapy, at five years follow-up from abdominoperineal resection, the patient was free from recurrence. Our case highlights the importance of penile examination during follow-up of many oncologic patients, in order to allow earlier diagnosis with a potential for more conservative penile surgery, also taking into consideration the good response to new oncologic drugs, as in our experience.

A Case of Penile Metastasis from Prostate Cancer, Identified by 68Ga-PSMA PET/CT, Mimicking Peyronie's Disease: A Diagnostic Challenge.

A 70-year-old man with high-risk prostate cancer (PCa) received radiation therapy and androgen deprivation therapy (ADT). The patient developed penile tenderness, compatible with Peyronie's disease upon physical examination. An ultrasound revealed a matching hypoechoic plaque and a thrombus in the vena dorsalis profunda, which were treated with anticoagulants. A follow-up ultrasound showed no abnormalities. Despite the use of analgesics, the patient suffered from persistent pain, later accompanied by an increasing PSA level of up to 7.5 ng/mL, despite ADT. 68Ga-PSMA PET/CT showed a PSMA uptake consistent with PCa penile metastasis. Due to severe pain and the presence of metastatic PCa, the patient was referred for penectomy. Histopathological analysis confirmed metastases originating from the PCa. This case underscores the importance of 68Ga-PSMA PET/CT in diagnosing PCa metastases and vigilance towards urogenital symptoms as potential indicators of metastases, despite the rarity of penile metastases.

The role of surgery in the treatment of neuroblastoma metastases at rare sites

PurposeTreatment of neuroblastoma metastases usually consists of chemotherapy and irradiation. However, in selected cases, surgical treatment is also indicated. In this study, we present three cases of patients with neuroblastoma metastases at rare sites that underwent surgery.Materials and methodsWe retrospectively analyzed data of patients who underwent surgery for neuroblastoma at our department of Pediatric Surgery and Pediatric Urology at the University Children’s Hospital in Tuebingen and selected those patients who had surgery explicitly for a metastasis.ResultsBetween 2002 and 2020, 277 children underwent surgical treatment for neuroblastoma. Three cases with metastases at exceptional sites are presented here after therapy according to protocols. One patient had a penile metastasis and received surgery including a plastic reconstruction. The patient showed no signs of erectile or urinary dysfunction at follow-up. Another patient had a metastasis in the proximal ulna, which remained vital even after exhausted treatment after two relapses. Afterward there was no restriction of movement of the extremity. The third patient had, amongst others, metastases to the pancreatic body and to the liver. Both were surgically removed during primary tumor resection. This patient died after local tumor relapse. The other two patients showed no evidence of tumor relapse after a follow-up of 18 and 17 months, respectively.ConclusionAlthough children with neuroblastoma often present with metastases, there is no recommendation for surgical treatment other than diagnostic biopsies. In case of persistence of metastasis or after exhaustion of high-risk therapy, surgical resection must be considered.

(368) Stuttering Priapism: A Rare Manifestation of Underlying Malignancy

(368) Stuttering Priapism: A Rare Manifestation of Underlying Malignancy

Primary Neuroendocrine Prostate Cancer with Penile Metastasis.

Supplemental material is available for this article.

Symptom palliation with QUAD Shot radiation therapy to penile metastasis derived from descending colon cancer: a case report.

A 54-year-old man was diagnosed with descending colon cancer with metastases in the liver, para-aortic lymph nodes, and penis, and chemotherapy was introduced after construction of a colostomy. The patient reported only mild penile pain at the time of diagnosis; however, the pain gradually worsened and interfered with his daily life. Opioids did not provide sufficient analgesia, and the patient developed dysuria and priapism. Through construction of a cystostomy, palliative radiotherapy with QUAD Shot regimen (14Gy in 4 fractions twice-daily on 2days repeated every 4weeks) to the penile metastasis was started for pain relief and tumor shrinkage. The radiation rapidly improved the penile symptoms, enabling opioid reduction and cystostomy removal. The patient remained pain-free and able to urinate on his own until his death. Metastatic penile tumors are rare, especially those derived from colon cancer. Penile metastases occur mainly in the late stages of cancer and may impair the patient's quality of life. In such cases, palliative radiotherapy, especially with QUAD Shot regimen, is useful with short treatment time, durable symptom control, and little adverse effect, maintaining quality of life.

Solitary Penile Metastasis from Prostate Cancer on 18F-Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography.

We report a case of a 66-year-old man with prostate cancer who underwent 18F-prostate-specific membrane antigen positron emission tomography/computed tomography for baseline staging that revealed primary lesion in prostate gland along with a solitary metastatic deposit in the penile shaft. Penile metastasis is rare and usually associated with widespread metastatic disease. Solitary penile metastasis is even rarer and can present as a unifocal, multifocal, or diffuse lesion. Early detection is important in guiding treatment and preventing complications.

A Rare Case of Penile Metastasis Secondary to Pancreatic Ductal Adenocarcinoma

A Rare Case of Penile Metastasis Secondary to Pancreatic Ductal Adenocarcinoma

Penile metastasis from rectal carcinoma: A case report

BACKGROUNDMetastasis to the penis is an unusual event, and penile metastasis from rectal carcinoma (PMRC) is extremely rare and associated with a dismal prognosis. Thus far, approximately 80 cases have been reported.CASE SUMMARYHerein, we report the case of a 49-year-old man with PMRC. The patient presented to the urology clinic with a complaint of penile pain during urination. The patient underwent the Dixon operation for rectal carcinoma 2 mo before the presentation. During hospitalisation, abdominal computed tomography revealed a nodular lesion on the left penis. The postoperative pathological examination revealed a typical intestinal-type adenocarcinoma. Previous cases of PMRC were retrieved from PubMed to characterise the clinicopathological features and identify the prognostic factors of PMRC.CONCLUSIONThe analysis suggested that approximately 24 mo is the median time to metastasis occurrence and 150 d is the survival time after diagnosis. Furthermore, poor pathological differentiation, lymph node involvement of the primary RC, metastasis time < 6 mo, penile metastatic nodule diameter > 1 cm, and treatment abandonment are negative predictors of survival outcomes. Close follow-up, surgical resection, chemotherapy, and radiotherapy may potentially improve the prognosis of patients.

Penile secondary lesions: a rare entity detected by PET/CT

While penile metastases are rare, PET/CT has facilitated their detection. We aimed to describe penile secondary lesions (PSL) identified by PET/CT. We reviewed 18F-FDG and Ga68-PSMA PET/CT records performed in a single center during May 2012-March 2020, for PSL. Of 16,774 18F-FDG and 1,963 Ga68-PSMA-PET scans, PSL were found in 24(0.13%) men with a mean age of 74. PSMA detected PSL in 12 with prostate cancer; FDG identified PSL in 4 with lymphoma, 3 with colorectal cancer, 2 with lung cancer, and one each with bladder cancer, pelvic sarcoma, and leukemia. Mean SUVmax of PSL was 7.9 ± 4.2 with focal uptake in 13(54%). Mean lesion size was 16.5 ± 6.8 mm; 8 at the penile root, 4 along the shaft, and 1 at the glans. CT detected loss of the penile texture in 15(63%). PSL were observed only during relapse or follow-up of disseminated disease. Among those with prostate cancer, PSA varied widely. Fifteen (62.5%) died, at a mean 13.3 ± 15.9 months following PSL demonstration, nine had non-prostate malignancies. PET/CT identified and characterized PSL in a fraction of cancer patients, most commonly those with prostate cancer. PSL universally surfaced in advanced disease, and signaled high mortality, especially in non-prostate cancers.

Penile Metastasis of Colorectal Cancer Mimicking Priapism with Acute Urinary Retention: A Rare Case

Background: Penile metastasis of colorectal carcinoma is a rare phenomenon in clinical setting. They normally manifest as penile lesion and acute urinary retention. However, presentation of priapism is exceedingly rare. Aims: Discussion of this rare presentation as well as the diagnostic processes and subsequent management. Case Presentation: A 54-year-old male with a history of colorectal cancer presents with acute urinary retention. Examination of the patient demonstrates a semi-erect penis, with multiple palpable nodules on the shaft and penile meatus. Histological and imaging findings indicate penile metastasis of colorectal cancer. Conclusion: Biopsy via cystoscopy is used to obtain definitive diagnosis of penile metastasis. Urinary drainage followed by further cancer intervention or palliative care is crucial for effective management.

Penile metastases in a case of carcinoma colon: A rare occurrence

Penile metastases in a case of carcinoma colon: A rare occurrence