Distant cutaneous metastases secondary to squamous carcinoma of the penis

Penile cancer normally spreads in a predictable manner to the regional lymph nodes: first inguinal and then the pelvic nodes. We report a case where the patient presented synchronously with secondary skin metastases and primary high grade penile squamous carcinoma. In addition the patient also had pulmonary metastases, loco regional spread to the groin nodes, liver metastases and tumour erosion of a right sided rib. The skin metastases appeared nodular, were firm in consistency and appeared intradermal. Skin metastases have been described for a number of solid malignancies - the clinician must have an index of suspicion to relate a less obvious primary lesion with secondary skin lesions. The patient died before chemotherapy could be administered.