title: Erectile dysfunction: initial symptom of a patient with lung cancer.
abstract: BACKGROUND
  Penile metastases are rare and represent the advanced stage of the primary tumor. The patients usually have a history of a previously diagnosed malignancy and when metastasis to penis occurs, the most common findings would be priapism, pain, and difficulty in voiding.
  
  
  OBJECTIVE
  We aimed to present a patient who had erectile dysfunction as the initial symptom of lung cancer. Besides the unusual clinical presentation, the sonographic and magnetic resonance imaging (MRI) findings of the penile metastasis were also not typical.
  
  
  METHODS
  A 57-year-old man with erectile dysfunction was admitted to the Department of Urology. On physical examination, there was a rigid, smooth, immobile, and painless mass at the base of the corpora cavernosa. Ultrasonography and MRI were performed in order to delineate the nature of the lesion.
  
  
  RESULTS
  Radiological findings could not lead to a certain diagnosis and the lesion could not be resected completely during the surgery. Therefore, biopsy of the corpus cavernosum penis was performed. The histopathological diagnosis was metastatic malignant epithelial tumor consistent with nonsmall cell carcinoma. Further investigations revealed a metastatic lung cancer.
  
  
  CONCLUSIONS
  Penile metastasis may rarely be the initial presentation of a malignancy and erectile dysfunction may be a seldom symptom.
authors.affiliation: Department of Urology, Medical Faculty, Ufuk University, Ankara, Turkey. ahmethakan75@yahoo.com
authors.forename: Ahmet Hakan
authors.initials: AH
authors.lastname: Haliloglu
authors.forename: Nuray
authors.initials: N
authors.lastname: Haliloglu
authors.forename: Evrim Eylem
authors.initials: EE
authors.lastname: Akpinar
authors.forename: Omur
authors.initials: O
authors.lastname: Ataoglu
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications*; D006801:Humans; D018783:Impotence, Vasculogenic / Q000209:etiology*; D008175:Lung Neoplasms / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010412:Penile Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D011859:Radiography; D013997:Time Factors