Penile Metastases of Recurrent Prostatic Adenocarcinoma without PSA Level Increase: A Case Report

Abstract

We report a case of penile metastases from recurrent prostatic adenocarcinoma that was the first sign of a widespread metastatic disease in the absence of any increase in prostate-specific antigen (PSA) level. In April 2011, an 80-year-old man presented to our Radiotherapy Unit with multiple palpable hard nodules in the penis, dysuria, and moderate perineal pain, 7 years after he had received radiotherapy for prostate cancer. Nodules in the penis had appeared in February 2011. The ultrasound and magnetic resonance (MR) imaging suggested the diagnosis of multiple penile metastases. A total body computed tomography scan revealed a systemic spread of the disease, with multiple metastases in the liver, bones, and lungs. PSA level was 0.126 ng/ml. A fine needle aspiration biopsy of the liver lesion was undertaken, and the histopathologic examination revealed the prostatic origin of the metastases, so androgen deprivation therapy was started. The diagnosis of metastases should be considered in a patient with prior history of prostate malignancies presenting with solid nodules in the penis, even if the PSA level is low.

Relevance of computed tomography and magnetic resonance imaging for penile metastasis after prostatectomy: uncommon case report and brief review of the literature

“…Despite this, we could find in the literature, a reported case of penile metastases without any increase of PSA levels [15], [16].…”

Rare sites of metastases in prostate cancer detected on ga-68 psma pet/ct scan—a case series

“…[ 6 ] Metastases to the penis are also uncommon, with less than 400 cases reported in the literature till date. [ 7 ] Liver metastases are also seen in only about 4.29% of carcinoma prostate cases. [ 8 ] In our series, cases are presented with Ga-68 PSMA uptake in these structures thus showing its promising role in the detection of lesions at uncommon sites.…”

Penile metastasis of sigmoid colon carcinoma: a rare case report

“…Treatment options include surgical excision, radiotherapy, and chemotherapy. The choice depends mainly on patients’ general clinical situation: type and extent of the primary tumor, presence of widespread metastatic disease, and type of symptoms [ 10 ]. Local surgical excision or radiotherapy is usually the most preferred.…”