Year : 2000 | Volume
: 16 | Issue : 2 | Page : 166--168
Priapism: An unusual presentation of testicular tumor in 62-year-old male
Swaroop Singh Gambhir, Shashank Shekhar Samaiyar, Udai Shankar Dwivedi, Pratap Bahadur Singh
Department of Urology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
Pratap Bahadur Singh
Department of Urology, Institute of Medical Sciences, Banaras Hindu University, Varanasi - 221 005
|How to cite this article:|
Gambhir SS, Samaiyar SS, Dwivedi US, Singh PB. Priapism: An unusual presentation of testicular tumor in 62-year-old male.Indian J Urol 2000;16:166-168
|How to cite this URL:|
Gambhir SS, Samaiyar SS, Dwivedi US, Singh PB. Priapism: An unusual presentation of testicular tumor in 62-year-old male. Indian J Urol [serial online] 2000 [cited 2020 Aug 6 ];16:166-168
Available from: http://www.indianjurol.com/text.asp?2000/16/2/166/22226
Neoplastic metastases to penis is quite rare. Till date, 277 cases of malignancy metastases to penis have been reported.  Out of these commonest sites were bladder 92 (33.2%), prostate 84 (30.3%) and kidney (6.9%). Till now penile metastases due to testicular tumor has been found in 11 cases (4%) only. We are reporting an interesting case of penile metastases due to embryonal cell carcinoma in a 62-year-old male presenting as priapism.
A 62-year-old male patient presented us in December '98 with painful erection of penis for last one and a half month. On examination patient was found to have 10+15 centimeter retroperitoneal lump in left upper abdomen. He had hepatomegaly and left testis was enlarged and nodular with absent testicular sensation. Penis was tender, erect and consistency was woodlike but glans was flaccid [Figure 1].
Routine laboratory investigations were normal. Ultrasound showed multiple secondaries in liver, retroperitoneal lymph-node metastases, ascites and multiple hypoechoic areas in left testis [Figure 2]. Patient refused any form of penile amputation. Patient underwent left high radical orchidectomy and cavernosal currettage with proximal spongiocavernosus shunt. Corpis cavernosus was fully fibrosed and left testis showed multiple pink flushy nodules on cut section. Histopathology revealed embryonal cell carcinoma of the testis [Figure 3]. The patient was put on bleemycin, methotroxate and cisplatin regimen (BEP) but unfortunately died within first cycle of chemotherapy.
Penile metastasis is an unusual presentation and it usually denotes terminal disease.' Metastases due to bladder, prostate and rectum is common due to close proximity and retrograde venous and lymphatic spread or extension along the nerves.
The most frequent sign of penile metastasis is priapism. Penile swelling, nodularity and ulceration have also been reported.  Haematuria and retention are also seen.  The therapy for metastatic lesion is generally palliative. Partial or total amputation is particularly effective in relieving symptoms. 50% of penile metastasis patients die within 6 months, with most of these patients having primary lesion in genitourinary tract. 
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