Acute urinary retention due to corpus cavernosum penile metastasis from lung adenocarcinoma after targeted therapy: a case report and review of the literature

Abstract

Background: Metastasis in penile corpus cavernosum from adenocarcinoma of lung is a rare but fatal disease, which was reported in cases without series studies. It causes various clinical symptoms seriously affecting the quality of life.

Case presentation: A 72-year-old male smoker patient, who had a history of adenocarcinoma of lung after targeted therapy 36 months before, was admitted to Jiangxi Cancer Hospital because of presenting with aggressive dysuria and penis pain for one hour. A Foley catheter was inserted into the patient's bladder with difficulty. Immediately do a bladder puncture. Emergency pelvic computed tomography (CT): a soft tissue nodule of 1.1 cm×1.4 cm was found in the cavernous area of the middle part of the penis, and the proximal urethra was dilated with a wide diameter of about 1.5 cm. The diagnosis of metastatic lung adenocarcinoma from the primary was made by CT-guided biopsy.

Conclusion: The penis may be a site of metastasis from primary lung cancer, especially for old patient. Metastasis to the penis usually indicates that the primary lung cancer is at an advanced stage and the prognosis is very poor. More research is necessary to understand the underlying mechanism of adenocarcinoma of lung metastasis.

Keywords: adenocarcinoma of lung; case report; metastasis; penile; targeted therapy.

Figure 1

(A) MRI image shows C3/C4 vertebral bodies and their right attachments presented bone destruction with soft tissue mass. (B) CT image shows a mass measure 3.5 cm×3.9 cm in the right lower lobe. (C) Bone scan image shows multiple bone metastases. (D) Fine needle aspiration biopsy show adenocarcinoma.

Figure 2

(A) CT image shows a mass measure 1.1 cm×1.4 cm in the middle cavernous body of penile with proximal urethral dilation. (B) MRI image shows a mass measure 1.2 cm×1.3 cm in the middle cavernous body of penile with local urethral stricture. (C) Electronic cystoscope image shows urethra was crushed. (D-F) During operation a fused nodule was found on the right side of the corpus cavernosum.

Figure 3

(A) Histopathological images of the nodule of corpus cavernosum penis show adenocarcinoma from primary lung cancer. H&E staining was performed. Immunohistochemical staining revealed that the tumor cells were positive for CK, TTF-1, NapsinA, CK7, Ki-67, and were negative for P40, and P63. Representative images are shown at ×200 magnification. (B) Histopathological images of the nodule of corpus spongiosum show adenocarcinoma from primary lung cancer. H&E staining was performed. Immunohistochemical staining revealed that the tumor cells were positive for CK, TTF-1, NapsinA, CK7, and were negative for GATA-3, P40, and P63. Representative images are shown at ×200 magnification. (C) Timeline of the patient’s diagnosis and treatment process.

Figure 4

(A) The survival time of patients diagnosed with corpus cavernosum penile metastasis from lung adenocarcinoma. (B) The age of patients diagnosed with corpus cavernosum penile metastasis from lung adenocarcinoma. (C) Penile lesion size of patients diagnosed with corpus cavernosum penile metastasis from lung adenocarcinoma.