Penile metastasis from carcinoma of the rectum: A case report :[PAUTHORS], 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 2022 May 21 ];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

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2	Perez 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.
3	Paquin 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.
4	Robey EL, Schellhammer PF. Four cases of metastases to the penis and a review of the literature. J Urol 1984; 132: 992-4.
5	Lopez 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.
6	Lange 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.
7	Rees BI. Secondary involvement of the penis by rectal cancer. Br J Surg 1975; 62(1): 77-9.