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Journal of Medical Case Reports

, 6:252

First Online: 21 August 2012Received: 11 November 2011Accepted: 21 March 2012DOI: 10.1186-1752-1947-6-252

Cite this article as: Karanikas, C., Ptohis, N., Mainta, E. et al. J Med Case Reports 2012 6: 252. doi:10.1186-1752-1947-6-252


IntroductionPenile metastases are an extremely rare occurrence, and most primary malignancies are located in the urinary bladder, prostate, rectum, and rectosigmoid. Although very few cases of penile metastases have been reported, those of lung cancer as the primary tumor are very rare. Among the latter, squamous cell carcinomas constitute the majority, whereas adenocarcinomas are almost exceptions. To the best of our knowledge, only two cases have been reported.

Case presentationWe report the case of a 59-year-old Greek man who presented with persistent cough and chest pain that had started one month prior to a medical appointment. A physical examination, complete laboratory work-up, computed tomography scanning of the chest, brain, and abdomen, pelvic magnetic resonance imaging, penile ultrasonography, bone scanning, and histological analyses were conducted. Afterward, a lung adenocarcinoma metastatic to the bones, brain, adrenals, lymph nodes, and penis was diagnosed. The primary lesion was a mass of 4cm in diameter in the apical segment of the lower lobe of the right lung. The patient was treated with bone and brain radiotherapy and various cycles of first- and second-line chemotherapy, and partial response was achieved five months after the initial appointment.

ConclusionsAlthough these metastatic sites are well known to occur from a primary pulmonary malignancy, penile metastasis is extremely rare. Its identification requires prompt awareness by the physician despite the dismal prognosis. Furthermore, since the penis usually is omitted from the physical examination and lung cancer is the leading cause of cancer-related deaths, more penile metastases may be detected in the future, making early detection and appropriate management of great importance.

KeywordsPenis Metastasis Lung Adenocarcinoma AbbreviationsCTComputed tomography

SCCSquamous cell carcinoma

TTF-1Thyroid transcription factor 1.

Electronic supplementary materialThe online version of this article doi:10.1186-1752-1947-6-252 contains supplementary material, which is available to authorized users.

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Author: Christos Karanikas - Nikolaos Ptohis - Evgenia Mainta - Christos S Baltas - Dimitris Athanasiadis - Simos Lechareas - Nikol

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