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Metastatic Tumors to the Penis

This study presents clinicopathologic and outcome features of 17 patients with metastatic tumor to the penis. Primary sites and histological types were as follows: 6 urothelial carcinomas of urinary bladder, 4 prostatic carcinomas (2 adenocarcinomas and 2 adenosquamous carcinomas), 2 colorectal adenocarcinomas, 2 pulmonary carcinomas (1 squamous cell carcinoma and 1 small cell carcinoma), 1 squamous cell carcinoma of base of the tongue, 1 cutaneous malignant melanoma, and 1 acute myeloid leukemia. Literature review revealed similar distribution of organ sites in 437 cases. Most of our tumors were metachronous. Interval between primary and penile metastasis ranged from 3 to 60 months (mean 16 months). Most of the patients presented with a penile mass. Priapism was observed in 4 patients. The shaft was the commonest anatomical site involved (12 cases). Tumor emboli were usually found in the erectile tissues (14 cases), mainly corpora cavernosa. A total of 14 patients died of disseminated disease. Time interval between primary tumor and penile metastasis ranged from 3 to 60 months (mean 19 months) and between diagnosis of penile metastasis and death ranged from 0.25 to 18 months (mean 6 months), significantly shorter (P = .0058). Patients presented a median survival of 18 months from primary treatment and 5 months after diagnosis of penile metastasis. None of the patients who died of disseminated cancer lived more than 18 months after pathological diagnosis. Clinical evidence of penile involvement in a patient with a known malignancy is an ominous sign and should alert the clinicians to the dismal prognosis.