Penile Metastasis From Prostatic Adenocarcinoma: A Case Report

Penile metastasis is a rare occurrence, particularly when it presents as the first clinical manifestation of an underlying malignancy. Most cases of penile metastasis arise from genitourinary cancers, particularly prostate and bladder carcinomas. This report discusses the case of a 68-year-old male patient who presented with hematuria and penile pain, accompanied by penile induration and tenderness on palpation during physical examination. Magnetic resonance imaging (MRI) revealed a locally aggressive prostatic tumor, confirmed as adenocarcinoma on biopsy, along with multiple nodular lesions in the corpus spongiosum and corpora cavernosa of the penis, exhibiting intermediate T2 signal intensity, heterogeneous enhancement on contrast-enhanced imaging, and significant diffusion restriction. These findings were strongly suggestive of penile metastasis in the context of disseminated prostate cancer, and the patient was managed with palliative hormone therapy and radiation to alleviate symptoms. This article highlights the rare presentation of penile metastasis as the initial sign of advanced prostate adenocarcinoma, exploring the clinical challenges associated with its diagnosis and the underlying mechanisms of metastatic spread. Emphasis is placed on the critical role of imaging in detecting penile involvement, which can often be challenging to diagnose through clinical examination alone. Despite its rarity, penile metastasis as the first manifestation of cancer requires early recognition and timely intervention. This report underscores the importance of considering penile metastasis in patients, even in the absence of a prior history of malignancy, and emphasizes the need for a comprehensive approach that includes advanced imaging techniques and palliative care strategies to optimize patient outcomes, which are generally poor in this clinical context.