Penile metastasis from primary transitional cell carcinoma of the bladder sparing the urethra

Abstract

Metastatic involvement of the penis is relatively infrequent. Metastasis of transitional cell carcinoma (TCC) is extremely rare. We report a case of bladder TCC with metastases to the penis that spares the urethra - a finding that, to the best of our knowledge, has not been previously reported. Of the documented mechanisms of metastatic transmission to the penis, we suspect the cause was retrograde lymphatic spread. In our case, a 59-year-old male presented to our clinic initially with phimosis and later developed gross hematuria. Subsequent cystoscopy noted the appearance of tumour extending into the prostate, as well as the appearance of extensive TCC throughout the bladder. Following transurethral resection of prostate and bladder tissue, which demonstrated high-grade urothelial carcinoma, the patient underwent a radical cystoprostatectomy. A year later, he developed worsening gross hematuria and we noted the appearance of primary penile squamous cell malignancy. He then underwent a partial penectomy. The histopathology evaluation result from the partial penectomy revealed infiltration of TCC in the glans penis, as well as invasion into the corpus spongiosum, with sparing of the urethra.