Advanced Penile Cancer Presenting With Renal Failure
Sarah Derby1, Jan Wallace2, Balaji Venugopal3
1Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Scotland, United Kingdom.
Oncology (Williston Park, N.Y.)
|July 15, 2021
Summary
A 67-year-old man presented with advanced penile cancer causing kidney injury and urinary obstruction. The squamous cell carcinoma extensively invaded the penis, scrotum, groin, and pubic bone, with lymph node involvement.
Area of Science:
- Urology
- Oncology
- Medical Imaging
Background:
- Penile cancer is a rare malignancy, often presenting late due to patient embarrassment.
- Delayed diagnosis can lead to extensive local invasion and poor prognosis.
Purpose of the Study:
- To report a case of advanced penile squamous cell carcinoma presenting with acute kidney injury.
- To highlight the diagnostic challenges and extensive local invasion in a late-stage presentation.
Main Methods:
- Clinical presentation of fatigue and nausea leading to discovery of a fungating penile mass.
- Diagnostic workup included urinalysis, bladder scan, CT staging, and pelvic MRI.
- Biopsy confirmed squamous cell carcinoma; multidisciplinary team confirmed bony invasion.
Main Results:
- The patient presented with stage III acute kidney injury secondary to urethral obstruction by penile cancer.
- Imaging revealed extensive tumor invasion of the penis, scrotum, bilateral groin soft tissues, and early pubic bone invasion.
- A suspicious inguinal lymph node was identified on CT staging.
Conclusions:
- Advanced penile squamous cell carcinoma can present insidiously with severe local invasion and systemic complications like acute kidney injury.
- Prompt and thorough investigation with imaging and biopsy is crucial for diagnosis and staging.
- Multidisciplinary team discussion is essential for managing complex cases of advanced penile cancer.
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