[Malignant priapism due to metastatic papillary renal cell carcinoma : a case report]

A 70-year-old man presented in December, 2010 with priapism persistent for over a month. The patient had no history of medications for erectile dysfunction, penis trauma, or traumatic sexual activities. A blood gas measurement of the cavernosum was performed, but only fibrosis tissue was aspirated and no blood was obtained. Color-flow Doppler imaging of the penis revealed blood flow in the corpora cavernosa of the penis, suggesting the occurrence of nonischemic priapism. Enhanced chest and abdominal computed tomography revealed a left renal cyst, and the wall of the cyst showed contrast enhancement. No other obvious obstructive mass or tumor was detected in the pelvic cavity. Gradually, necrotic changes of the glans penis appeared, and total penectomy was performed. Histopathological examination of penectomy tissue specimens suggested papillary renal cell carcinoma metastases to the penis. Consequently, open left radical nephrectomy was performed. Pathological diagnosis revealed papillary renal cell carcinoma pT2, and the patient was diagnosed with stage IV (pT2N0M1) renal cell carcinoma. Treatment was provided by intravenous temsirolimus therapy that resulted in partial remission and stable disease, which in turn relieved cancer pain.