Penile Metastasis from Primary Bladder Cancer: A Study of 8 Cases and Review of the Literature

Background: Penile metastases from primary bladder cancer are extremely rare. Case Report: The medical records of 8 patients who presented with metastatic penile carcinoma originating from bladder between 2002 and 2010 were analyzed. The main complaint was a painless nodule (6 cases), priapism (1 case), and penile pain (1 case). All of the penile metastases were metachronous. The interval between primary cancer and penile metastases ranged from 1 to 100 months (mean 26.4 months). Total penectomy combined with systemic chemotherapy was the treatment of choice in 4 cases. 1 patient only accepted external beam radiotherapy, and 3 patients only accepted chemotherapy due to disseminated disease. The time interval between penile metastases and death ranged from 4 to 23 months (mean 11.4 months). Conclusion: Penile metastases secondary to primary bladder cancer are rare and represent a challenging problem. The common mode of spread to the penis is by retrograde venous route. The overall outcome is very poor, and most patients will die within 1 year despite systemic chemotherapy and supportive care. Radical ablative surgery is justified only for symptomatic relief.