Relevance of computed tomography and magnetic resonance imaging for penile metastasis after prostatectomy: uncommon case report and brief review of the literature

Abstract

Penile metastasis from prostate cancer represents a rare condition, associated with poor prognosis. In the literature, authors have reported less than 500 cases of secondary penile cancers, and among these cases of metastases, only 33% are from prostate cancer. Overall reported rate of survival is about 1-24 months. Here, we present an uncommon case of penile metastasis from prostatic adenocarcinoma, with particular focus on the role of computed tomography and magnetic resonance imaging in diagnosis and follow-up.

Keywords: diagnostic imaging; metastasis; penis; prostate cancer.

Fig. 1

CT scan on axial (A, B) and multiplanar reconstruction in the sagittal and coronal planes (C, D) detects a nodule on the left side of corpus cavernosum (indicated by white arrow in all figures) with an early contrast enhancement after iodinated contrast agent injection. In addition, CT reveals an ipsilateral hydrocele (D). CT, computed tomography.

Fig. 2

MRI T1-weighted images on the axial plane (A) and T2-weighted images on the axial and sagittal planes (B, C) showing an oval-shaped area, hypointense on both sequences (white arrow) that is localized on the left side of corpus cavernosum. On dynamic sequences, after paramagnetic contrast agent injection, the lesion shows early contrast enhancement in the arterial phase (D), and persistent enhancement in the delayed phases (E, F). MRI, magnetic resonance imaging.

Fig. 3

Histologic findings of surgical biopsy. Fibromuscular tissue characterized by an infiltration from a poorly differentiated carcinoma (panel A, hematoxylin-eosin, 10×), showing a positive reaction with the anti-prostate-specific antigen antibody at the immunohistochemistry (panel B, 10×).