陳祺方^{1, 2}、陳俐臻^{1, 2}

¹馬偕紀念醫院泌尿科, ²馬偕醫學院

Chi-Fang, Chen ^{1, 2}. Li-Chen, Chen^{1, 2}

¹Department of Urology, Mackay Memorial Hospital, Taipei, Taiwan

²Department of Medicine, Mackay Medical College, Taipei, Taiwan

 

Background

Metastatic tumor to penis is uncommon. In the past literature reviews, since 1870, fewer than 500 cases have been reported. The most penile secondary tumors originated in organs of the genitourinary tract. The remainders are gastrointestinal origin. To date, primary tumor from sarcoma origin is extremely rare. We presented a teenager that had recurrent sarcoma of right femur with penile metastasis.

 

Case presentation

This 20-year-old male patient was diagnosed infantile fibrosarcoma over right femur when he was 16 days old. He was stable after neoadjuvent chemotherapy and debulking surgery. Until 5 months ago, because of right leg pain and swelling, recurrent tumor was suspected. After excision, the pathology report showed recurrent fibrosarcoma. However, 2 months after operation, right thigh swelling with tenderness occurred. Firm nodule over glans of penis was also mentioned. Penile metastasis was suspected and biopsy was performed. Within 2 weeks, symptoms as priapism, hematuria and inguinal lymph node enlargement had progressed rapidly, voiding difficulty with urine retention was also complained. The patient scumbbed in 35 days after admission, because of pneumonia with septic shock . The pathology report disclosed pleomorphic sarcoma with penile metastasis.

 

Conclusion

Penile metasitasis are largely from pelvis organs. After literature review, this is first teenager case that secondary penile tumor metastasized from sarcoma of bone. It presented with palpable mass, and then progressed with priapism. The patient with metastasis tumor to penis has dismal prognosis and symptoms progressed faster than we thought.