1
|
Zhang KC, Li WJ, Xu HX, Liang HM, Yang Q. A patient with penile metastasis secondary to small cell lung cancer successfully treated with PD-1 inhibitors and chemotherapy: a case report and literature review. Front Oncol 2025; 15:1484365. [PMID: 40071100 PMCID: PMC11893422 DOI: 10.3389/fonc.2025.1484365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2024] [Accepted: 02/03/2025] [Indexed: 03/14/2025] Open
Abstract
Background Penile metastasis is an uncommon condition, with most primary malignancies originating in the abdominal cavity and pelvis. There have been very few reported cases originating from lung cancer, most of squamous cell carcinoma without small cell lung cancer. Methods We presented a case of penile metastasis secondary to small cell lung cancer, along with a review of relevant literature from the CNKI database. Results A 73-year-old male presented with a one-month history of palpable swelling in the penis without any chest symptoms. Beside penile lesion, PET/CT imaging also revealed a lesion in the left lobe of the lung, as well as multiple enlarged lymph nodes in the left hilum, mediastinum, and left supraclavicular fossa. Fiberoptic biopsy confirmed small cell lung cancer for the pulmonary mass, while biopsies of the penile mass confirmed metastatic small cell carcinoma. The patient received first-line treatment of 6 cycles of PD-1 inhibitor (Toripalimab) combined with etoposide and cisplatin, achieving a partial response (PR). Subsequently, second-line therapy of etoposide and cisplatin regimen and later-line therapies of Irinotecan followed by Anlotinib were administered. The overall survival was approximately 2 years. Conclusion Penile metastasis from small cell lung cancer is extremely rare. Treatment strategies based on guidelines for small cell lung cancer had been proven effective approaches.
Collapse
Affiliation(s)
- Kai-cong Zhang
- Department of Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Wei-jun Li
- Pediatric Emergency Department, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Hui-xin Xu
- Department of Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Hui-min Liang
- Department of Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Qiong Yang
- Department of Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| |
Collapse
|
2
|
Yan W, Fu H, Liu H, Liu Z, Qi X, Chen T. Acute urinary retention due to corpus cavernosum penile metastasis from lung adenocarcinoma after targeted therapy: a case report and review of the literature. Front Oncol 2024; 14:1278245. [PMID: 38496763 PMCID: PMC10940509 DOI: 10.3389/fonc.2024.1278245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/13/2024] [Indexed: 03/19/2024] Open
Abstract
Background Metastasis in penile corpus cavernosum from adenocarcinoma of lung is a rare but fatal disease, which was reported in cases without series studies. It causes various clinical symptoms seriously affecting the quality of life. Case presentation A 72-year-old male smoker patient, who had a history of adenocarcinoma of lung after targeted therapy 36 months before, was admitted to Jiangxi Cancer Hospital because of presenting with aggressive dysuria and penis pain for one hour. A Foley catheter was inserted into the patient's bladder with difficulty. Immediately do a bladder puncture. Emergency pelvic computed tomography (CT): a soft tissue nodule of 1.1 cm×1.4 cm was found in the cavernous area of the middle part of the penis, and the proximal urethra was dilated with a wide diameter of about 1.5 cm. The diagnosis of metastatic lung adenocarcinoma from the primary was made by CT-guided biopsy. Conclusion The penis may be a site of metastasis from primary lung cancer, especially for old patient. Metastasis to the penis usually indicates that the primary lung cancer is at an advanced stage and the prognosis is very poor. More research is necessary to understand the underlying mechanism of adenocarcinoma of lung metastasis.
Collapse
Affiliation(s)
- Wei Yan
- Department of Thoracic Oncology, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Cancer Institute, Nanchang, China
| | - Hui Fu
- Department of Pathology, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Huiqun Liu
- Department of Thoracic Oncology, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Cancer Institute, Nanchang, China
| | - Zhentian Liu
- Department of Thoracic Oncology, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Jiangxi Cancer Institute, Nanchang, China
| | - Xueliang Qi
- Department of Urology, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Tanxiu Chen
- Institute of Neurology and Department of Neurology, Jiangxi Academy of Clinical Medical Sciences, The First Affiliated Hospital of Nanchang University, Nanchang, China
- Jiangxi Key Laboratory of Translational Cancer Research, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, China
| |
Collapse
|
3
|
Yin GL, Zhu JB, Fu CL, Ding RL, Zhang JM, Lin Q. Metachronous isolated penile metastasis from sigmoid colon adenocarcinoma: A case report. World J Clin Cases 2022; 10:11658-11664. [PMID: 36387791 PMCID: PMC9649525 DOI: 10.12998/wjcc.v10.i31.11658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/24/2022] [Accepted: 10/17/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Sigmoid colon adenocarcinoma has a high incidence among gastrointestinal tumors, and it very rarely metastasizes to the penis. The literature reports that the prognosis after penile metastasis is generally poor, with a median survival of about 9 mo. Metachronous isolated metastasis to the penis originating from sigmoid colon adenocarcinoma has not been reported so far. Here, we report a case of sigmoid colon adenocarcinoma with isolated penile metastasis occurring 2 years after surgery. The mass was pathologically confirmed as metastatic adenocarcinoma, and oral chemotherapy with capecitabine was given after surgery. The tumor did not recur during the 2-year follow-up period.
CASE SUMMARY A 79-year-old man presented to the urology department with "a mass located at the root of the penis since 1 mo". Enhanced computed tomography (CT) examination suggested a 12 mm × 10 mm × 9 mm nodule at the root of the right penile corpus cavernosum. Cranial, pulmonary, and abdominal CT; and bone scan did not show any tumorigenic lesions. The carcinoembryonic antigen (CEA) level was slightly elevated (6.01 ng/mL, reference value 0-5 ng/mL). The patient had undergone laparoscopic radical sigmoidectomy for sigmoid colon cancer 2 years ago. The postoperative pathology showed moderately differentiated adenocarcinoma of the sigmoid colon, and the stage was PT2N0M0. The penile mass was removed under general anesthesia. The postoperative pathology showed adenocarcinoma, and immunohistochemistry showed CDX2(+), CK20(+), and Villin(+). Based on the medical history, he was diagnosed with penile metastasis from sigmoid colon adenocarcinoma. The CEA level returned to normal (3.34 ng/mL) 4 d after surgery. Oral chemotherapy with capecitabine was given subsequently, and tumor recurrence was not found during the 2-year follow-up period.
CONCLUSION To our knowledge, this is a rare case of metachronous isolated penile metastasis from sigmoid colon adenocarcinoma. The penis is a potential site of metastasis of colon adenocarcinoma, and the possibility of metastasis should be considered in patients with a history of colon cancer who present with a penile mass. Solitary penile metastasis can be removed surgically, in combination with chemotherapy, and it may have good long-term outcomes.
Collapse
Affiliation(s)
- Guo-Lin Yin
- Department of Urology, Taizhou First People's Hospital, Taizhou 318020, Zhejiang Province, China
| | - Jiang-Bo Zhu
- Department of Urology, Taizhou First People's Hospital, Taizhou 318020, Zhejiang Province, China
| | - Cheng-Lin Fu
- Department of Pathology, Taizhou First People's Hospital, Taizhou 318020, Zhejiang Province, China
| | - Ru-Liang Ding
- Department of Anorectology, Taizhou First People's Hospital, Taizhou 318020, Zhejiang Province, China
| | - Jun-Miao Zhang
- Department of Urology, Taizhou First People's Hospital, Taizhou 318020, Zhejiang Province, China
| | - Qian Lin
- Department of Urology, Taizhou First People's Hospital, Taizhou 318020, Zhejiang Province, China
| |
Collapse
|
4
|
A Rare Case of Penile Metastases as a Harbinger of Primary Pulmonary Adenosquamous Carcinoma. Case Rep Radiol 2018; 2018:8361368. [PMID: 29785317 PMCID: PMC5892242 DOI: 10.1155/2018/8361368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 02/19/2018] [Indexed: 11/24/2022] Open
Abstract
Although lung cancer has a high propensity for distant metastatic disease, penile metastases from primary lung neoplasms are considered particularly rare. A 71-year-old male presented to our hospital with a rapidly enlarging hard palpable penile mass. MR imaging demonstrated two penile masses centered in the left and right corpus cavernosa. Subsequent CT imaging revealed a spiculated pulmonary mass in the right upper lobe with PET/CT, MRI, and surgical exploration, demonstrating evidence of metastases to the left adrenal gland, right subscapularis muscle, brain, and small bowel. Tissue sampling of lesions in the small bowel, right subscapularis muscle, and penis demonstrated histopathology consistent with an adenosquamous carcinoma which in combination with the appearance of the right upper lobe mass on PET/CT imaging suggested the patient's lung cancer as the primary lesion. Prior to our case, pulmonary adenosquamous carcinoma metastasizing to the penis has only been reported once in the literature. Herein, we report a rare case of penile metastases as the presenting sign of metastatic pulmonary adenosquamous carcinoma characterized with PET/CT and MR imaging.
Collapse
|
5
|
Cocci A, Hakenberg OW, Cai T, Nesi G, Livi L, Detti B, Minervini A, Morelli G, Carini M, Serni S, Gacci M. Prognosis of men with penile metastasis and malignant priapism: a systematic review. Oncotarget 2018; 9:2923-2930. [PMID: 29416825 PMCID: PMC5788693 DOI: 10.18632/oncotarget.23366] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Accepted: 09/04/2017] [Indexed: 12/18/2022] Open
Abstract
Introduction: Metastases to the penis are rare, but can have severe consequences. The aim of this study was to systematically review the literature in order to gain more information on the presentation and prognosis of this metastatic disease. We reviewed the literature relating to all case reports, series and reviews about penile metastasis, from 2003 to 2013, through a Medline search. We identified 63 articles and 69 patients. Metastases were located on the root (38.8%), the shaft (38.8%) or the glans (22.2%) of the penis. The diagnosis of penile metastasis was made after the primary cancer had been diagnosed. The most common presentation was a single small penile nodule. Ten patients reported priapism. The median survival time after diagnosis of penile metastasis was 10 months (range 6-18 months). A Kaplan-Meier analysis has shown that the patients presenting with priapism and those with metastases from non-urologic tumors have a significantly worse prognosis (age adjusted Log Rank: p=0.037 for priapism vs. no priapism and p=0.045 for urologic vs. non urologic). There are prognostic differences based on the presentation of penile metastases. Survival is substantial and treatment should therefore take into account symptoms improvement and quality of life.
Collapse
Affiliation(s)
- Andrea Cocci
- Department of Urology, University of Florence, Florence, Italy
| | | | - Tommaso Cai
- Department of Urology, Santa Chiara Hospital, Trento, Italy
| | | | | | | | | | | | - Marco Carini
- Department of Urology, University of Florence, Florence, Italy
| | - Sergio Serni
- Department of Urology, University of Florence, Florence, Italy
| | - Mauro Gacci
- Department of Urology, University of Florence, Florence, Italy
| |
Collapse
|
6
|
Efared B, Ebang GA, Tahirou S, Tahiri L, Sidibé IS, Erregad F, Sow A, Hammas N, Farih MH, Chbani L, El Fatemi H. Penile metastasis from rectal adenocarcinoma: a case report. BMC Res Notes 2017; 10:564. [PMID: 29110729 PMCID: PMC5674733 DOI: 10.1186/s13104-017-2901-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 11/01/2017] [Indexed: 12/18/2022] Open
Abstract
Background Despite its rich vasculature, the penis is rarely involved by metastasis. Since the first description of penile metastasis in 1870, fewer than 500 cases have been reported in the literature. The pelvic organs are the main source of primary tumors that metastasize to the penis. Case presentation We report a case of a 46-year-old Arabic man who presented with erectile dysfunction and painful induration of the penile root. Eight months ago, he had undergone abdomino-perineal resection for rectal adenocarcinoma after neo-adjuvant chemotherapy. The histological evaluation of the resected specimen disclosed a ypT3N0 tumor with a poor therapeutic response (around 5%). An adjuvant chemotherapy by XELOX (oxaliplatin plus capecitabine) regimen has been prescribed for the patient. The magnetic resonance imaging (MRI) showed tumoral infiltration of penile structures and a biopsy of the corpora cavernosa was performed. The histological examination disclosed a penile metastasis from the patient’s previous rectal adenocarcinoma. The patient is still alive and continues his adjuvant therapy. Conclusion Penile secondary tumors are very rare and usually occur in patients with advanced tumor stages. A diagnosis of penile metastasis should be considered in patients with a history of malignancies who present with genitourinary symptoms. These patients have a dismal prognosis as they often die in the year after the diagnosis.
Collapse
Affiliation(s)
- Boubacar Efared
- Department of Pathology, Hassan II University Hospital, Fès, Morocco.
| | | | - Soufiane Tahirou
- Department of Radiology, Hassan II University Hospital, Fès, Morocco
| | - Layla Tahiri
- Department of Pathology, Hassan II University Hospital, Fès, Morocco
| | | | | | - Aboubakry Sow
- Department of Urology, Hassan II University Hospital, Fès, Morocco
| | - Nawal Hammas
- Department of Pathology, Hassan II University Hospital, Fès, Morocco.,Laboratory of Biomedical and Translational Research, Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdellah University, Fès, Morocco
| | - Moulay H Farih
- Department of Urology, Hassan II University Hospital, Fès, Morocco.,Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdellah University, Fès, Morocco
| | - Laila Chbani
- Department of Pathology, Hassan II University Hospital, Fès, Morocco.,Laboratory of Biomedical and Translational Research, Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdellah University, Fès, Morocco
| | - Hinde El Fatemi
- Department of Pathology, Hassan II University Hospital, Fès, Morocco.,Laboratory of Biomedical and Translational Research, Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdellah University, Fès, Morocco
| |
Collapse
|
7
|
Gorospe L, González-García A, González-Gordaliza MC, Gómez-Dos-Santos V, García-Gómez-Muriel I, Olmedo-García ME, Muñoz-Molina GM. Metastasis to the corpus spongiosum of the penis in a patient with lung cancer causing acute urine retention. Surgery 2017; 163:474-475. [PMID: 28919053 DOI: 10.1016/j.surg.2017.07.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 07/27/2017] [Accepted: 07/27/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Luis Gorospe
- Department of Radiology, Ramón y Cajal University Hospital, Madrid, Spain.
| | | | | | | | | | | | | |
Collapse
|
8
|
Guo LC, Li G, Wang XM, Zhang M, Huang JA, Chen YB. Penile metastases from primary lung cancer: Case report and literature review. Medicine (Baltimore) 2017; 96:e7307. [PMID: 28658136 PMCID: PMC5500058 DOI: 10.1097/md.0000000000007307] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Metastasis to the penis from primary lung cancer is quite rare. To improve the understanding, we present a case diagnosed as penile metastasis from primary lung cancer and review the literature. METHODS One case report and retrospectively analysis penile cancer patient secondary from primary lung cancer. RESULTS The patient complained of perineal pain and burning on urination for about 2 months. On physical examination, painful nodular masses at the base of left side of the corpora cavernosa were found. 18F-fluorodeoxyglucose positron emission tomography/CT (PET/CT) scan showed that maximum standardized uptake value (SUVmax) in left side corpora cavernosa and right hilar increased to 12.0 and 13.5 respectively. On flexible bronchoscopy checking, stenosis of the opening of apical segmental and posterior segmental bronchi of right upper lobe was found. The lateral segmental bronchi of left lower lobe was obstructed by a neoplasm. The pathological result was primary pulmonary adenosquamous carcinoma (ASC). Two months later, total penectomy was performed. The pathological result was penile ASC derived from pulmonary. On reviewing the literature, there are 39 cases reported. The patient we present is the 40 one. The average age at diagnosis was (60.5 ± 10.7) years old. The most common symptom was mass, followed by priapism, pain. The overall survival time was (4.5 ± 3.9) months. CONCLUSIONS The penis may be a site of metastasis from lung cancer, especially for old patient. Metastasis to the penis usually indicates that the primary lung cancer is at an advanced stage and the prognosis is very poor.
Collapse
Affiliation(s)
| | | | | | - Mi Zhang
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jian-An Huang
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yan-Bin Chen
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| |
Collapse
|
9
|
Dong Z, Qin C, Zhang Q, Zhang L, Yang H, Zhang J, Wang F. Penile metastasis of sigmoid colon carcinoma: a rare case report. BMC Urol 2015; 15:20. [PMID: 25887957 PMCID: PMC4371621 DOI: 10.1186/s12894-015-0014-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 02/26/2015] [Indexed: 12/18/2022] Open
Abstract
Background Metastasis to penis usually arises from genitourinary organs, but in rare cases, metastasis comes from the sigmoid colon. Furthermore, very few cases of penile metastasis of primary sigmoid colon carcinoma have been reported. Case presentation We described a case of a 53-year-old man with penile metastasis of sigmoid colon carcinoma along with a review of the literature. Physical examination revealed two subcutaneous nodules on the glans penis. Biopsy of the nodules showed that penile metastasis of sigmoid colon carcinoma. Conclusion Metastasis of sigmoid colon carcinoma to the penis is extremely rare, which presents an advanced form of sigmoid colon carcinoma, therefore survival is extremely shortened. Although treatment of penile metastasis is almost always palliative, it is important to recognize this unusual manifestation so that timely appropriate treatment can be initiated. Early recognition may enhance survival rate of these patients.
Collapse
Affiliation(s)
- Zhengbang Dong
- Department of Dermatology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, 210009, China.
| | - Chao Qin
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
| | - Qijie Zhang
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
| | - Lei Zhang
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
| | - Haijing Yang
- Department of Dermatology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, 210009, China.
| | - Jingdong Zhang
- Department of Dermatology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, 210009, China.
| | - Fei Wang
- Department of Dermatology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, 210009, China.
| |
Collapse
|
10
|
Du Plessis D, Van Der Merwe A, Heyns C. Penile metastases from primary bronchus carcinoma – A case report and literature review. AFRICAN JOURNAL OF UROLOGY 2015. [DOI: 10.1016/j.afju.2014.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
11
|
Blanc E, Calais J, Cardot V, Mabille L. 18F-FDG PET/CT scan in malignant priapism with diffuse pulmonary adenocarcinoma metastatic invasion of both corpus spongiosum and cavernosum. Eur J Nucl Med Mol Imaging 2013; 41:588-9. [DOI: 10.1007/s00259-013-2644-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 11/13/2013] [Indexed: 10/25/2022]
|
12
|
Penile metastasis of osteosarcoma: a rare case report. Asian J Androl 2013; 15:841-2. [PMID: 24036919 DOI: 10.1038/aja.2013.102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Revised: 07/08/2013] [Accepted: 07/12/2013] [Indexed: 11/08/2022] Open
|
13
|
Karanikas C, Ptohis N, Mainta E, Baltas CS, Athanasiadis D, Lechareas S, Katirtzoglou N, Xynogalos S. Pulmonary adenocarcinoma presenting with penile metastasis: a case report. J Med Case Rep 2012; 6:252. [PMID: 22909155 PMCID: PMC3441777 DOI: 10.1186/1752-1947-6-252] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Accepted: 03/21/2012] [Indexed: 11/10/2022] Open
Abstract
Introduction Penile metastases are an extremely rare occurrence, and most primary malignancies are located in the urinary bladder, prostate, rectum, and rectosigmoid. Although very few cases of penile metastases have been reported, those of lung cancer as the primary tumor are very rare. Among the latter, squamous cell carcinomas constitute the majority, whereas adenocarcinomas are almost exceptions. To the best of our knowledge, only two cases have been reported. Case presentation We report the case of a 59-year-old Greek man who presented with persistent cough and chest pain that had started one month prior to a medical appointment. A physical examination, complete laboratory work-up, computed tomography scanning (of the chest, brain, and abdomen), pelvic magnetic resonance imaging, penile ultrasonography, bone scanning, and histological analyses were conducted. Afterward, a lung adenocarcinoma metastatic to the bones, brain, adrenals, lymph nodes, and penis was diagnosed. The primary lesion was a mass of 4cm in diameter in the apical segment of the lower lobe of the right lung. The patient was treated with bone and brain radiotherapy and various cycles of first- and second-line chemotherapy, and partial response was achieved five months after the initial appointment. Conclusions Although these metastatic sites are well known to occur from a primary pulmonary malignancy, penile metastasis is extremely rare. Its identification requires prompt awareness by the physician despite the dismal prognosis. Furthermore, since the penis usually is omitted from the physical examination and lung cancer is the leading cause of cancer-related deaths, more penile metastases may be detected in the future, making early detection and appropriate management of great importance.
Collapse
Affiliation(s)
- Christos Karanikas
- Radiology Imaging Department, "G, Gennimatas" General Hospital, 154 Mesogeion Avenue, Athens, 11527, Greece.
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Mearini L, Colella R, Zucchi A, Nunzi E, Porrozzi C, Porena M. A review of penile metastasis. Oncol Rev 2012; 6:e10. [PMID: 25992200 PMCID: PMC4419641 DOI: 10.4081/oncol.2012.e10] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 06/02/2012] [Accepted: 06/07/2012] [Indexed: 12/16/2022] Open
Abstract
Penile cancer as primary disease is relatively rare in developed countries. The penis is a rare site of metastases in spite of its rich vascularization. Approximately 500 cases have been reported in the literature; almost 70% of primary lesions are of pelvic origin (from genitourinary or recto-sigmoid primary tumors). We describe a case of penile metastasis from lung cancer. The rarity of the event prompted us to also explore related reviews and discuss the incidence, physiopathology, diagnosis and therapy of penile secondary cancer.
Collapse
Affiliation(s)
| | - Renato Colella
- Pathological Anatomy and Histology Department, University of Perugia, Italy
| | | | | | | | | |
Collapse
|
15
|
Chaux A, Amin M, Cubilla AL, Young RH. Metastatic tumors to the penis: a report of 17 cases and review of the literature. Int J Surg Pathol 2010; 19:597-606. [PMID: 20075023 DOI: 10.1177/1066896909350468] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This study presents clinicopathologic and outcome features of 17 patients with metastatic tumor to the penis. Primary sites and histological types were as follows: 6 urothelial carcinomas of urinary bladder, 4 prostatic carcinomas (2 adenocarcinomas and 2 adenosquamous carcinomas), 2 colorectal adenocarcinomas, 2 pulmonary carcinomas (1 squamous cell carcinoma and 1 small cell carcinoma), 1 squamous cell carcinoma of base of the tongue, 1 cutaneous malignant melanoma, and 1 acute myeloid leukemia. Literature review revealed similar distribution of organ sites in 437 cases. Most of our tumors were metachronous. Interval between primary and penile metastasis ranged from 3 to 60 months (mean 16 months). Most of the patients presented with a penile mass. Priapism was observed in 4 patients. The shaft was the commonest anatomical site involved (12 cases). Tumor emboli were usually found in the erectile tissues (14 cases), mainly corpora cavernosa. A total of 14 patients died of disseminated disease. Time interval between primary tumor and penile metastasis ranged from 3 to 60 months (mean 19 months) and between diagnosis of penile metastasis and death ranged from 0.25 to 18 months (mean 6 months), significantly shorter (P = .0058). Patients presented a median survival of 18 months from primary treatment and 5 months after diagnosis of penile metastasis. None of the patients who died of disseminated cancer lived more than 18 months after pathological diagnosis. Clinical evidence of penile involvement in a patient with a known malignancy is an ominous sign and should alert the clinicians to the dismal prognosis.
Collapse
Affiliation(s)
- Alcides Chaux
- Instituto de Patología e Investigación, Asunción, Paraguay
| | | | | | | |
Collapse
|
16
|
Haliloglu AH, Haliloglu N, Akpinar EE, Ataoglu O. Erectile dysfunction: initial symptom of a patient with lung cancer. J Sex Med 2009; 8:3511-4. [PMID: 19674251 DOI: 10.1111/j.1743-6109.2009.01431.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Penile metastases are rare and represent the advanced stage of the primary tumor. The patients usually have a history of a previously diagnosed malignancy and when metastasis to penis occurs, the most common findings would be priapism, pain, and difficulty in voiding. AIM We aimed to present a patient who had erectile dysfunction as the initial symptom of lung cancer. Besides the unusual clinical presentation, the sonographic and magnetic resonance imaging (MRI) findings of the penile metastasis were also not typical. METHODS A 57-year-old man with erectile dysfunction was admitted to the Department of Urology. On physical examination, there was a rigid, smooth, immobile, and painless mass at the base of the corpora cavernosa. Ultrasonography and MRI were performed in order to delineate the nature of the lesion. RESULTS Radiological findings could not lead to a certain diagnosis and the lesion could not be resected completely during the surgery. Therefore, biopsy of the corpus cavernosum penis was performed. The histopathological diagnosis was metastatic malignant epithelial tumor consistent with nonsmall cell carcinoma. Further investigations revealed a metastatic lung cancer. CONCLUSIONS Penile metastasis may rarely be the initial presentation of a malignancy and erectile dysfunction may be a seldom symptom.
Collapse
|