Spongious Penile Metastasis from Urothelial Carcinoma of the Bladder: A Case Report and Literature Review

Abstract

Author(s): Diango Keita*, Sara Nejjari, Serge Kumbi, Mehdy Alem, Zineb Bibah, Chaymae Chbihi, Hafssa El Hilali, Samia El Hakim, Abir Oufrid, Lamiae Amaadour, Karima Oualla, Zineb Benbrahim, Samia Arifi, Nawfel Mellas

Penile metastases are exceedingly rare and are typically secondary to genitourinary malignancies such as bladder or prostate cancer. Their diagnosis is often delayed and associated with a poor prognosis. We report the case of a 49-year-old patient who had been managed in 2016 for a urothelial carcinoma of the bladder, treated with a radical cyst prostatectomy and Bricker-type urinary diversion (pT2N0M0). Nine years later, he presented with a painful swelling of the penis evolving over three months. MRI and CT imaging revealed a tumoral process involving the corpus spongiosum and the penile urethra, with trans-parietal extension and an inguinal lymphadenopathy, without evidence of bladder recurrence. Histological and immunohistochemically analyses were consistent with a urothelial carcinoma. The patient underwent a penectomy with right inguinal lymph-node dissection, followed by concomitant chemo radiotherapy. Conclusion: Penile metastases of urothelial origin are rare but represent severe complications of urothelial carcinomas. They may occur many years after cyst prostatectomy.

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