Metastatic Tumors to the Penis

Despite its rich vascularity metastatic tumors to the penis are rare with about 400 worldwide cases reported, mostly as single cases.4,123 The majority of these tumors originate in the genitourinary and gastrointestinal tract. Prostatic adenocarcino-mas and bladder urothelial carcinomas represent together almost two-thirds of all secondary penile tumors with an equal distribution between them. Metastases from clear cell renal carcinomas and testicular germ cell tumors have also been reported, as well as urothelial carcinomas originating in the renal pelvis, ureter, or proximal urethra but to a much lesser frequency. Tumors originating in the gastrointestinal tract represent about one-fifth of all cases of secondary penile tumors. Adenocarcinomas from the lower tract (rectum and distal colon) account for two-thirds of all GI metastatic carcinomas but tumors arising in the stomach or esophagus are occasionally reported. About 5% of penile metastasis originates in the lungs or, more rarely, the upper airways. Other anecdotal primary sites include tongue, seminal vesicles, bone, thyroid gland, cutaneous melanomas, chordomas, Ewing's sarcomas, synovial sarcomas, and jaw chondrosarcomas.4,124-130

The preferred anatomical location is the penile shaft, mainly the corpora cavernosa, but secondary foci can also be found in the glans, corpus spongiosum, or even foreskin or outer skin. Microscopically, tumor cells are predominantly found permeating the vascular spaces of erectile tissues. The histological aspect is similar to the primary tumor and diagnosis is straightforward in most cases given that the majority of patients present a previous or concurrent history of malignancy elsewhere. A penile secondary tumor as the primary manifestation of a disseminated malignant disease is a very rare event. In the presence of penile secondary involvement prognosis is dismal and the majority of patients die within 6 months from diagnosis.4

Dealing With Erectile Dysfunction

Dealing With Erectile Dysfunction

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