|Year : 2003 | Volume
| 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
Department of Surgery, KMC, Attavar, Mangalore - 575 001
Source of Support: None, Conflict of Interest: None
| 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.
Keywords: Metastasis, penile.
|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;19:165-6
| Introduction|| |
Penis is an uncommon site for metastasis.  It occurs mostly secondary to tumors in the bladder, prostate, and rectum in that order. , 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.  Most of the cases reported in the literature have been from bladder, prostate and rectum. , The mode of spread is either direct invasion or in retrograde manner through venous or lymphatic flow. 
Patient may present with symptoms like painful penile nodule, priapism, urinary obstruction etc.  The diagnosis can usually be made with needle biopsy.  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. , Palliative chemotherapy and radiotherapy have been tried with varying results. , Total penectomy may rarely be necessary to palliate intractable pain. 
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