title: Penile metastasis from primary bladder cancer: a study of 8 cases and review of the literature.
abstract: BACKGROUND
  Penile metastases from primary bladder cancer are extremely rare.
  
  
  METHODS
  The medical records of 8 patients who presented with metastatic penile carcinoma originating from bladder between 2002 and 2010 were analyzed. The main complaint was a painless nodule (6 cases), priapism (1 case), and penile pain (1 case). All of the penile metastases were metachronous. The interval between primary cancer and penile metastases ranged from 1 to 100 months (mean 26.4 months). Total penectomy combined with systemic chemotherapy was the treatment of choice in 4 cases. 1 patient only accepted external beam radiotherapy, and 3 patients only accepted chemotherapy due to disseminated disease. The time interval between penile metastases and death ranged from 4 to 23 months (mean 11.4 months).
  
  
  CONCLUSIONS
  Penile metastases secondary to primary bladder cancer are rare and represent a challenging problem. The common mode of spread to the penis is by retrograde venous route. The overall outcome is very poor, and most patients will die within 1 year despite systemic chemotherapy and supportive care. Radical ablative surgery is justified only for symptomatic relief.
authors.affiliation: Department of Urology, Fudan University Shanghai Cancer Center, China.
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Zhu
authors.forename: Xu-Dong
authors.initials: XD
authors.lastname: Yao
authors.forename: Hai-Liang
authors.initials: HL
authors.lastname: Zhang
authors.forename: Yi-Jun
authors.initials: YJ
authors.lastname: Shen
authors.forename: Dan
authors.initials: D
authors.lastname: Huang
authors.forename: Ding-Wei
authors.initials: DW
authors.lastname: Ye
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000175:diagnosis* / Q000556:secondary* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010412:Penile Neoplasms / Q000175:diagnosis* / Q000556:secondary* / Q000601:surgery; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000601:surgery*