Indian Journal of Urology
: 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


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
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Full Text


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.


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]


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