Penis and scrotum - Metastases to penis

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Penis and scrotum

Other malignancies

Metastases to penis

Editor: Antonio Cubilla, M.D. and Alcides Chaux, M.D. (see Author/Reviewers page)

Revised: 25 May 2010, last major update May 2010

Definition

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● Secondary penile involvement by malignant tumors that originate elsewhere

Epidemiology

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● Mean age 67 years (range 53 to 79 years)

Sites

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● Mainly penile shaft; rarely glans and foreskin

Etiology

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● Primaries usually have GU origin (mainly prostate and urinary bladder) followed by GI (mainly colon-rectum) and respiratory system (Int J Surg Pathol Jan 14 2010 [Epub ahead of print])

● Other primary sites are rare

Clinical features

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● Usually presents with a tumor mass

● Priapism in 27-40% of all cases

● Rarely pain, hematuria and impaired urination

● Most metastases are metachronous (not simultaneous) with a known primary, with an interval of 16 months (range 3-60 months) between primary and metastases

● Mean survival 18 months from primary treatment and 5 months after diagnosis of penile metastasis

Clinical images

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The ventral glans mucosa is slightly Small nodules are seen in the

elevated and discolored reflecting coronal sulcus

metastatic carcinoma in the lamina propria

Gross description (Macroscopy)

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● Ill-defined, usually multicentric, tumor mass

● Tumor size varies from millimeters to 4 cm

Gross images

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Left: involvement of both corpora Longitudinal section of penile shaft shows

cavernosa and periurethral tissue replacement of corpora cavernosa by tan-white

Right: massive obliteration of penile solid tumor tissue. The glans is uninvolved

compartments

Transverse section through shaft shows

massive replacement of corpora cavernosa

by tumor with distortion of tunica albuginea

Top: Multiple discrete tumor masses involving corpus cavernosum

Bottom: Diagram shows relationship of tumor to various anatomic

landmarks (gcs-glans corpus spongiosum, alb-tunica albuginea,

f-foreskin, cc-corpus cavernosum, ca-carcinoma).

Urothelial carcinoma of renal pelvis

Micro description (Histopathology)

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● Microscopic features of primary tumor retained in most cases

● Tumor emboli permeate vascular spaces of erectile tissues, mainly corpora cavernosa

● Tumor foci may also be found in lamina propria, penile fascia or skin

Micro images

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Tumor cells plug periurethral blood vessels Tumor cells line corpus cavernosum vessels

Massive involvement of erectile tissue. Tumor replaces much of the corpora

cavernosa at autopsy

Two nodules of metastatic colonic Metastatic prostatic carcinoma is PSA+

adenocarcinoma are present in the corpus

cavernosum. The patient had a sigmoid

carcinoma resected 1 year previously

and presented with multiple penile nodules.

Urothelial carcinoma of renal pelvis

Cytology images

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Metastatic urothelial carcinoma of bladder

End of Penis and scrotum > Other malignancies > Metastases to penis

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