A magnetic resonance imaging scan of the penis was performed at the time of the previous procedure which demonstrated possible partial cavernosal thrombosis at the base of the cavernosa as well as plaques within the tunica albuginea. On physical examination, the patient had a rigid penile shaft and glans, with pain on palpation. There were no palpable nodules Inhibitors,research,lifescience,medical and no overlying skin necrosis of the glans. There was also decreased sensation along the shaft. Penile ultrasound at this time demonstrated flow of 15

mL/s. Given the urgency of the presentation, the patient underwent surgical repair of priapism and penile exploration. During the procedure, a cavernostomy did not demonstrate any Selleckchem SCR7 significant amount of bleeding, raising concerns for a nonvascular etiology of the priapism. Inhibitors,research,lifescience,medical Further exploration demonstrated

an extensive amount of fibrosis and necrosis of each of the cavernosal bodies. Intraoperative biopsies of the corpus cavernosa revealed adenocarcinoma consistent with metastatic prostate cancer. Postoperatively, the patient continued to complain of decreased penile sensation. A bone scan Inhibitors,research,lifescience,medical demonstrated metastases to the pelvic region, and computer tomography images showed metastatic disease in left lower lung, liver, and abdominal and pelvic lymph nodes. The patient and family were counseled extensively on the extent of his disease as well as treatment options. He was then referred to oncology for further medical management and palliative treatment. Discussion Secondary penile lesions are a rare phenomenon, first described in 1870 by Eberth. Reviews of published case reports reveal that organs

along the genitourinary tract, Inhibitors,research,lifescience,medical such as the prostate and bladder, are the most common primary sites.2 Cherian and colleagues compiled a review of published cases of secondary penile tumors up to September 2006, listing a total of 372 primary site-specific cases of metastatic penile lesions.3 Using a PubMed literature search for published human cases with English abstracts and the keywords “penile metastasis”, “penile metastases”, Inhibitors,research,lifescience,medical “malignant priapism”, and “secondary” AND “malignancy” AND “penis”, we present here an updated listing of the reported cases of metastatic much lesions to the penis published since September 2006 (Table 1). In our extensive search we tabulated 29 published case reports of penile metastases since September 2006,8–35 including our present case. Building on the data from Cherian and associates, there are a total of 394 published cases of secondary penile malignancies to date. Of note, Zheng and colleagues found 22 cases of primary lung cancers metastasizing to the penis, a much higher count than that of Cherian and colleagues.26 Of the 394 documented cases, 129 (33%) cases were of prostate origin, and bladder cancer was a close second with 118 published cases (30%).