Penile Metastasis from a T1b Prostate Carcinoma

Abstract

Penile metastasis from incidental prostate carcinoma has not been described to date. Case Report: The case of a 72-year-old man affected by penile metastasis from incidental prostate carcinoma is described. In March 1998, the patient underwent prostate surgery for lower urinary tract symptoms related to benign prostatic obstruction. Histological examination revealed an incidental adenocarcinoma of the prostate. The pre-operative prostate-specific antigen (PSA) value was 3.6 ng/ml. A prostate biopsy in the peripheral prostate lobes was negative. PSA progressively rose to 8 ng/ml. The prostate biopsy was repeated and was still negative. The patient was subjected to radiotherapy, as a result of which his PSA fell to 0.7 ng/ml. 4 years after prostatectomy, the PSA rose again and the patient underwent hormonal therapy. The PSA fell to < 0.001 ng/ml. In May 2004, the patient reported a painful, erythematous nodule on his penis glans. Surgical biopsy showed a metastasis from prostate adenocarcinoma and he underwent partial penectomy. Due to disease progression, the patient underwent medical therapy. PSA and testosterone were always at minimum levels. 20 months later the patient died. Conclusion: We underline the uncertainty of the biological behaviour and optimal management of incidentally identified prostate carcinoma. In addition, we highlight that biological and clinical progression could be the consequence of inadequate treatment recommendations.

Differenzierungsverlust eines Adenokarzinoms der Prostata nach Hormontherapie

“…Das Prostatakarzinom als häufigster Tumor des Mannes metastasiert nur in weniger als 0,3 % der Fälle in Penis oder Hoden [5]. In den beschriebenen Fällen ist meist eine antiandrogene Therapie des Prostatakarzinoms vorausgegangen [6,7]. Es wird vermutet, dass hierdurch bestimmte Subtypen selektioniert werden.…”

Rare presentation of penile cancer: a case report

“…Rare penile cancers include melanoma, basal cell carcinoma, sarcomas, fibrous histiocytoma and secondary carcinomas. 1,4,5 Squamous cell cancer usually starts on glans or coronal sulcus as a nodule, foul smelly ulcer or cauliflower like mass, which invades corpora cavernosa as it progresses sparing the urethra until late in the course of the disease.…”

Prognosis of men with penile metastasis and malignant priapism: a systematic review

“…The most common primary malignancies with penile metastases are urogenital cancers (69%) followed by cancers from gastrointestinal origin (19%) [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. The clinical manifestations are heterogeneous, ranging from penile nodules to masses, with or without ulceration, obstructive or irritative urinary symptoms, hematuria or priapism.…”

“…The clinical manifestations are heterogeneous, ranging from penile nodules to masses, with or without ulceration, obstructive or irritative urinary symptoms, hematuria or priapism. It has been suggested that the occurrence of priapism as a consequence of malignancy may be a prognostic factor to take into account [ 2 , 3 , 5 , 10 , 12 ].…”