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Case of the Month

November 2008

Patient Data: 73 year old male

Clinical Info: Palpable lesions in the penis in a patient treated for prostate carcinoma

Longitudinal image of the penis with an irregular hypoechoic hypervascularized mass

Longitudinal image of the penis with multiple irregular hypoechoic masses

Longitudinal image of the penis with multiple hypoechoic masses

Transverse image of the penis with a hypoechoic mass

Transverse image of the penis with an irregular hypoechoic mass

Color Doppler image shows that the masses are hypervascular

Diagnosis Penile metastases of a prostate carcinoma.
Metastasis to the penis is rare, despite rich vascularization and complex circulation.
The most common symptoms are penile induration and swelling. Treatments, all of which must be considered merely palliative, consist of local tumor excision, radiation therapy, cytostatic and hormone therapy, possibly with partial or total penis amputation.
In this case the patient already had a suprapubic catheter. He also had bone metastases. Treatment was started with hormone therapy. Unfortunately the effects of the treatment were poor. The overall prognosis of patients with penis metastasis is poor.

For more lesions in the penis see

Osther PJ, Løntoft E. Metastasis to the penis. Case reports and review of the literature.Int Urol Nephrol. 1991;23(2):161-7

Nakayama F, Sheth S, Caskey CI, Hamper UM. Penile metastasis from prostate cancer: diagnosis with sonography.
J Ultrasound Med. 1997 Nov;16(11):751-3.

Copyright © Dr. T.S.A. Geertsma, Ziekenhuis Gelderse Vallei, Ede, The Netherlands. All rights reserved.

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