Isolated, PSMA-negative penile metastasis from castration resistant prostate adenocarcinoma, identified by FDG-PET

Penile metastases are a rare entity and are associated with widespread metastatic disease. It is associated with significant morbidity with a poor prognosis. There have been few case reports about metastatic prostate adenocarcinoma to the penis. Diagnosis is often clinical, however, the use of PSMA PET has a high sensitivity. We report the first case of metastatic castration resistant prostate cancer with an isolated penile metastatic site. This was not identified on conventional staging or PSMA PET, but using FDG PET. A radical penectomy was performed with ongoing survival.