Penile metastasis from urothelial carcinoma of the bladder: An exceptionally rare localization

Penile metastasis from urothelial carcinoma is exceedingly rare (<1%) and typically indicates advanced disseminated disease. We report a 60-year-old male who underwent radical cystoprostatectomy for high-grade urothelial carcinoma (pT4aN1). Before adjuvant chemotherapy, he developed indurated violaceous penile nodules, biopsy-confirmed as cutaneous metastasis. Staging CT revealed systemic relapse involving lungs, liver, and bone. As he was ineligible for cisplatin, he received gemcitabine-carboplatin, since enfortumab vedotin was unavailable locally. This case highlights the aggressive potential of high-grade urothelial carcinoma and the importance of prompt histological evaluation of unusual penile lesions in bladder cancer patients.