|Year : 2001 | Volume
| Issue : 1 | Page : 91-92
Carcinoma of bladder with metastasis to penis: Case report of a patient
A Munshi, DP Singh, S Ghoshal, AK Mandal
Departments of Radiotherapy and Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
Department. of Radiotherapy and Oncology, PGIMER, Chandigarh- 160012
Source of Support: None, Conflict of Interest: None
Keywords: Bladder; Penis; Carcinoma
|How to cite this article:|
Munshi A, Singh D P, Ghoshal S, Mandal A K. Carcinoma of bladder with metastasis to penis: Case report of a patient. Indian J Urol 2001;18:91-2
| Introduction|| |
The common modes of spread of bladder cancer are local, lymphatic and blood. An organ that can peculiarly and rarely be involved is the penis. We are presenting such a case.
| Case Report|| |
A patient was diagnosed as Ca urinary bladder and treated with XRT 35Gy/15# /3 weeks to pelvis. One week after XRT completion patient started complaining of having to strain while passing urine. Local examination revealed a nodule 2 x 2 cm in the penoscrotal junction [Figure]. FNAC of the lesion revealed metastatic carcinoma. The patient was started on palliative. XRT 15Gy/5# was started by incident field to the local area with special wax bolus. After 10 months of follow-up period, the nodular swelling showed partial response and was less tense.
| Discussion|| |
The common modes of spread of bladder cancer are local, lymphatic and blood. The hematogenous route usually causes spread to the lungs, liver and bone. Another organ that can peculiarly be involved is the penis. There are four possible ways of spread to the penis: a) direct infiltration; b) during instrumental examination; c) hematogenous - either through arterioles, retrograde venous stream or as a paradoxical embolism through an atrial septal defect; and d) through retrograde lymphatic permeation.
The most frequent sign of penile metastasis is priapism. Penile swelling, nodularity and ulceration have been reported. Since penile lesion is associated with advanced disease, survival after its presentation is limited to about a year. Surgery can be done for small isolated lesions but surgical cure is difficult to achieve if proximal corporal invasion is present. Penectomy is occasionally indicated after failure of other modalities to palliate intractable pain. Radiotherapy can be given in these cases.
We treated one case with radiotherapy using a special wax bolus on the swelling. Alternatively these patients can be treated with electrons.
| References|| |
|1.||Abehouse BS, Abeshouse GA. Metastatic tumors of the penis: A review of literature and a report of two cases. Cancer 1984; 54: 1720-1722. |
|2.||Mukamel E, Farrer J. Smith RB, deKernion JB. Metastatic carcinoma to penis: When is total penectomy indicated? Urology 1987; 29: 15-18. |
|3.||Robey EL, Schellhammer PF. Four cases of metastases to the penis and a review of the literature. J Urol 1984; 132: 992-994. |
[Figure - 1]