Published online Jul 6, 2022. doi: 10.12998/wjcc.v10.i19.6609
Peer-review started: December 2, 2021
First decision: February 7, 2022
Revised: February 15, 2022
Accepted: May 7, 2022
Article in press: May 7, 2022
Published online: July 6, 2022
Metastasis 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.
Herein, 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.
The 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.
Core Tip: Rectal carcinoma (RC) is a clinically common malignant tumour. Mainstream treatment methods are chemotherapy and surgery. Clinically, the liver is the most common metastatic site of RC. We report a rare case of penile metastasis from RC following a Dixon operation. Combined with the analysis of the cases indexed in PubMed, urinary discomfort occurring within 6 years after surgery is a concern. Early detection of suspicious lesions is a favourable factor for patient survival. After the discovery of penile metastasis, providing appropriate active treatment has positive effects on the prognosis of patients. The treatment plan should be based on the patient’s response to chemotherapy or radiotherapy, general condition, and willingness to choose the current best treatment. However, clinicians should avoid negative treatment.