title: Penile metastasis from primary transitional cell carcinoma of the renal pelvis: first manifestation of systemic spread.
abstract: BACKGROUND
  Almost one-third of all penile metastases are detected at the same time as a primary tumor, whereas the remaining two-thirds are detected a mean of 18 months after the discovery of the primary tumor. Cutaneous metastasis of transitional cell carcinoma (TCC) is extremely rare and generally accepted as the late manifestation of a systemic spread.
  
  
  METHODS
  We report the first case of simultaneous penile and lung metastases from a primary TCC of the renal pelvis in a 76-year-old man, that occurred 8 years after a left nephroureterectomy.
  
  
  CONCLUSIONS
  This case report underscores the importance of physical examinations of the skin of patients who undergo surgical procedures for TCC from bladder as well as from the upper urinary tract, including those seemingly without metastatic disease, because of the possibility of skin and penile metastatic spread.
authors.affiliation: Department of Surgery, Urology Unit, S, Chiara Hospital, Pisa, Italy. g.pomara@libero.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Pomara
authors.forename: Ilaria
authors.initials: I
authors.lastname: Pastina
authors.forename: Maurizio
authors.initials: M
authors.lastname: Simone
authors.forename: Paolo
authors.initials: P
authors.lastname: Casale
authors.forename: Gabriella
authors.initials: G
authors.lastname: Marchetti
authors.forename: Francesco
authors.initials: F
authors.lastname: Francesca
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000556:secondary*; D006801:Humans; D007682:Kidney Pelvis / Q000473:pathology*; D008297:Male; D010386:Pelvic Neoplasms / Q000473:pathology*; D010412:Penile Neoplasms / Q000556:secondary*