以惡性陰莖異常勃起作為晚期泌尿上皮癌的初始症狀
虞容
臺大醫院
Malignant partial priapism as a presenting symptom of advanced urothelial carcinoma
Jung Yu
National Taiwan University Hospital
Abstract
Penile metastasis or direct invasion is a rare condition which indicates a disseminated disease and poor prognosis. Malignant priapism may present as a clinical presentation if the involvement of corpora cavernosa leads to blockage of venous drainage. Most case reports of such condition demonstrated refractory malignancies even with aggressive treatment. Symptoms often developed years after the first diagnosis of primary malignancy, while cases of penile metastasis/invasion as the first diagnosis is extremely rare.
Here we present a case of a 55-year-old male with malignant priapism as one of his initial presentations of advanced urothelial carcinoma. He initially presented with right buttock pain, bilateral inguinal mass, lower urinary tract symptoms, and priapism for one month. Bladder and urethra tumor, with invasion of corpus cavernosum, bilateral inguinal lymphadenopathy, and multiple axial and proximal bone metastases were found. To date, there was no reported case of urothelial carcinoma with synchronous penile metastasis/direct invasion. We review current literature on penile metastasis and direct invasion causing malignant priapism, and discuss the mechanism, pathophysiology, and outcome of this disease.