Metastatic Tumors of the Penis: A Report of 8 Cases and Review of the Literature

The purpose of this study was to report the clinical characteristics, treatments, and outcomes of secondary penile cancers and review the literature of this rare condition.

The records of 8 patients with metastatic penile cancer treated at our hospital from 2006 to 2013 were analyzed. A search of medical databases was conducted.

Patient symptoms included penile mass (n = 7, 5 had concomitant pain) and acute urine retention (n = 1). The primary cancers included bladder, lung, gastric, liver, and prostate malignancies and 1 case of pulmonary epithelioid hemangioendothelioma. The longest time from diagnosis of the primary cancer to metastatic penile cancer was 16 years and the shortest was 7 months. Six patients were treated with phallectomy, 1 with resection of the mass, and 1 with only a biopsy because of advanced metastatic disease. Five patients are deceased at the time of this report, and the longest and shortest survival times (from the diagnosis of primary cancer to the death) were 16 years and 9 months, respectively. The literature review identified 17 cases reported since 2011, bringing the total number of reported cases to 480. Genitourinary cancer, primarily bladder and prostate, account for approximately 70 of the primary cancer sites and gastrointestinal cancers account for approximately 21%. Approximately half of the patients had died of their disease within 1 year of the diagnosis of penile metastasis.

The prognosis of metastatic penile cancer is poor. Most primary cancers are in the urologic or gastrointestinal systems. Surgery and adjunctive therapy may improve symptoms, but fail to prolong survival.

Below:  Penile metastasis from lung squamous cell carcinoma. (A) Longitudinal section of the corpora cavernosum of the penis after phallectomy. The cancer invaded the full-length penis (from balanus to root, red circle), and superficial skin ulceration was also observed. (B) Histological examination with hematoxylin and eosin stain (magnification ×200) showed squamous cell carcinoma of the corpora cavernosum of the penis, moderately to poorly differentiated cells, with massive necrosis and cancer thrombus in the vasculature (red arrows).

Below:  Representative histopathological images of penile metastases with different primary tumors. All images are hematoxylin and eosin stained, ×200 magnification. (A) Epithelioid hemangioendothelioma, primary lung. (B) Advanced urothelial cancer, primary bladder. (C) Advanced urothelial cancer, primary bladder. (D) Angiosarcoma, primary liver. (E) Adenocarcinoma, primary prostate. (F) Poorly differentiated adenocarcinoma, primary stomach. (G) Invasive papillary urothelial carcinoma, primary bladder.

Full article at: http://goo.gl/IJt9B6

By: Ke Zhang, MD, MS, Jun Da, MD, MS, Hai-jun Yao, MD, MS, Da-chao Zheng, MD, MS, Zhi-kang Cai, MD, Yue-qing Jiang, MD, Ming-xi Xu, MD, MS, and Zhong Wang, MD, PhD

Department of Urology and Andrology (KZ, JD, HY, DZ, ZC, YJ, MX, ZW), Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Correspondence: Zhong Wang; Ming-Xi Xu, Department of Urology and Andrology, Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai 200011, China (e-mail: moc.anis@0102gnawgnohz).

  

More at:  https://twitter.com/hiv_insight