PRIMARY ADENOCARCINOMA, SIGNET-RING, AND TRANSITIONAL-CELL CARCINOMA OF THE BLADDER WITH PENILE METASTASIS

This article reports a rare case of primary signet-ring cell carcinoma of the bladder with transitional cell and adenocarcinoma variants and metachronous metastases to the penis and lungs. This combination of l esions has not previously been reported. Together, they portend widesp read dissemination and an early demise as is frequently the case with signet-ring cell carcinomas arising in other organs such as the breast and gastrointestinal tract. The optimal therapeutic intervention for this myriad of neoplasms with metastasis to the penis has yet to be as certained because of the rarity of the lesions. Early diagnosis and an aggressive surgical approach appear to offer the best chance for qual ity survival and possible cure.