Indian Journal of Urology
CASE REPORT
Year
: 2003  |  Volume : 19  |  Issue : 2  |  Page : 165--166

Penile metastasis from carcinoma of the rectum: A case report


Shivananda Prabhu, K Ramachandra Pai, Erel AI Diaz, CC Joshua, Sawan Ala, Manoj Bobby 
 Department of Surgery, Kasturba Medical College Hospital, Mangalore, India

Correspondence Address:
Shivananda Prabhu
Department of Surgery, KMC, Attavar, Mangalore - 575 001
India

Abstract

Penile metastases are extremely uncommon. When they do occur the primary lesion is most often in one of the pelvic organs. Patient may present with a painful nodule, priapisfn and urinary obstruction. Treatment is usually pal­liative. Aggressive surgical approach may benefit care­fully selected patients who have no other clinical metastatic lesions.



How to cite this article:
Prabhu S, Pai K R, Diaz EA, Joshua C C, Ala S, Bobby M. Penile metastasis from carcinoma of the rectum: A case report.Indian J Urol 2003;19:165-166


How to cite this URL:
Prabhu S, Pai K R, Diaz EA, Joshua C C, Ala S, Bobby M. Penile metastasis from carcinoma of the rectum: A case report. Indian J Urol [serial online] 2003 [cited 2021 Dec 4 ];19:165-166
Available from: https://www.indianjurol.com/text.asp?2003/19/2/165/37155


Full Text

 Introduction



Penis is an uncommon site for metastasis. [1] It occurs mostly secondary to tumors in the bladder, prostate, and rectum in that order. [1],[2] We present a case of penile metas­tasis from an adenocarcinoma of rectum.

 Case Report



An 86-year-old male presented with altered bowel hab­its. He was diagnosed to have adenocarcinoma of rectum and was offered abdominoperineal resection. Patient was not willing for surgery and was discharged at request. He was then lost to follow-up for 1 year after which he pre­sented with constipation and a painful nodule in the pe­nis. He had features of partial urinary obstruction. Fine needle aspiration cytology revealed metastasis from ad­enocarcinoma of rectum.

As the patient was poor risk for surgery, only sigmoid colostomy and perineal urethrostomy were fashioned to divert fecal and urinary streams and the patient was given external radiotherapy. With narcotic analgesics the patient had adequate pain relief.

 Comments



Secondary deposits in the penis occur very rarely. [1] Most of the cases reported in the literature have been from bladder, prostate and rectum. [1],[2] The mode of spread is either direct invasion or in retrograde manner through venous or lymphatic flow. [3]

Patient may present with symptoms like painful penile nodule, priapism, urinary obstruction etc. [4] The diagnosis can usually be made with needle biopsy. [5] As most of these patients will have disseminated disease, search for vis­ceral metastases has to be made.

Prognosis for these patients remains poor. Aggressive surgical approach offers the only chance for longterm sur­vival especially in patients who don't have clinical metastases elsewhere. [6],[7] Palliative chemotherapy and ra­diotherapy have been tried with varying results. [4],[5] Total penectomy may rarely be necessary to palliate intractable pain. [5]

References

1Musci R, Del Boca C, Ferrari C, Gregnani GC. Penile metastasis of prostatic carcinoma: a case report. Arch Ital Urol Nefrol Androl 1991; 63(1): 173-6.
2Perez LM, Shumway RA. Carson CC. Fisher SR, Hudson WR. Pe­nile metastasis secondary to supraglottic squamous cell carcinoma: review of literature. J Urol 1992; 147(1): 157-60.
3Paquin AJ Jr, Roland SI. Secondary carcinoma of the penis: a review of the literature and a report of 9 new cases. Cancer 1956; 9: 626.
4Robey EL, Schellhammer PF. Four cases of metastases to the penis and a review of the literature. J Urol 1984; 132: 992-4.
5Lopez De Alda A, Rodriguez Minon Cifuentes JL, Garcia de la Pena E, Brito Martinez M, Bauluz del Rio A, Barat A. Penile me­tastasis of prostatic carcinoma. Apropos of a case. Actas Urol Esp 1990; 14(2): 163-4.
6Lange G, Fagot H, Faulques B, Hoepffner JL, Lange S. Penile me­tastasis of recto-sigmoid adenocarcinoma. Apropos of a case. Ann Chir 1997; 51(3): 294-6.
7Rees BI. Secondary involvement of the penis by rectal cancer. Br J Surg 1975; 62(1): 77-9.