Metastases to the penis from carcinoma of the prostate

A 58-year-old man presented with dysuria at the Osaka Medical College Hospi tal in November 1996. Laboratory examination revealed elevated serum prosta te-specific antigen (PSA) to > 100 ng/mL. Adenocarcinoma of the prostate wi th metastasis to the bone was diagnosed after a biopsy of the prostate and bone scintigraphy; hormonal therapy was administered. Although bone metasta sis was well controlled and the serum PSA level declined to within normal l evels (2.0 ng/mL), several painless nodules were found on the penile glans. Biopsy of the nodules showed that the penile tumor was a metastasis from t he prostate cancer. The patient underwent partial penectomy for relief from penile pain. The serum PSA level showed no elevation 3 months after the pa rtial penectomy, suggesting that careful observation of prostate cancer pat ients is necessary, even when oseous metastasis is well controlled and seru m PSA levels are kept within normal ranges by hormonal therapy. The case al so indicates that urologists should consider the possibility of metastasis to the penis from prostate cancer.