Indian Journal of Urology
CASE REPORT
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

Correspondence Address:
Pratap Bahadur Singh
Department of Urology, Institute of Medical Sciences, Banaras Hindu University, Varanasi - 221 005
India




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 Jan 19 ];16:166-168
Available from: http://www.indianjurol.com/text.asp?2000/16/2/166/22226


Full Text

 Introduction



Neoplastic metastases to penis is quite rare. Till date, 277 cases of malignancy metastases to penis have been reported. [1] 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.

 Case Report



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.

 Discussion



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. [2] Haematuria and retention are also seen. [3] 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. [4]

References

1Burgers JK. Drago JR, Badalament RA. Penile cancer: clinical pres­entation. diagnosis and staging. Urol Clin North Am 1992:19:247-256.
2Abeshouse BS. Abeshouse Ga. Metastatic tumors of the penis. A review of the literature and a report of two cases. J Urol 1961: 86: 99-101.
3Belville WD. Cohen JA et al. Secondary penile malignancies: the spectrum of presentation. J Surg Oncol 1992: 51: 134-137.
4Mukamel E. Farrer J. Smith RB. De Kernion JB. Metastatic carci­noma to penis: when is total penectomy indicated? Urology 1987: 29: 15-18.