Penile metastases from primary bronchus carcinoma – A case report and literature review

IntroductionThe penis is an uncommon site of secondary metastases, and in most cases the primary tumour is found in the bladder, prostate, rectum or sigmoid colon. It is an extremely rare secondary metastatic site of lung cancer, with only 28 cases found in a review of the current literature. The majority of these cases were squamous cell carcinoma, with only 3 cases of adenocarcinoma.Case presentationOur case is a 55-year-old builder who presented with a painfully enlarged penis and loss of weight. He had a smoking history and was cachectic, with generalised lymphadenopathy and a firm mass on his left olecranon. His penis contained multiple firm nodules. Complete laboratory and imaging workup were done. Findings revealed a bronchial adenocarcinoma with multiple distant metastases, with the penile deposits as presenting symptoms. Management was with single high dose palliative half body irradiation. He survived 2 months after the presentation of penile metastasis.ConclusionsCases of metastases to the penis are very rare and often carry a grave prognosis, as it is a late manifestation of malignant disease. The average survival from the diagnosis of penile metastases in our review was just under 4 months. It is however important to be aware and recognise this rare phenomenon, and differentiate it from primary penis cancer. Treatment of penile metastases is mostly palliative, but much can be done to improve the patient's quality of life. Early correct diagnosis may also alter the treatment of the primary tumour.