Renal cell carcinoma involving penis and testis: unusual initial presentations of metastatic disease

Solitary parenchymal metastases of renal cell carcinoma to the penis or testis are rare. We report 1 case of each: in one instance the patient presented with priapism and an asymptomatic primary tumor; in the other, the metastasis presented as an acute change in a long-standing hydrocele more than one year after nephrectomy. Both patients had either positive margins at resection or recurrence after resection of the metastasis. While long-term, disease-free survival has been reported after orchiectomy for isolated metastatic disease, penile involvement appears to carry a very poor prognosis.