Priapism as the initial manifestation of a penile and lower limb cutaneous metastasis of prostate adenocarcinoma with low serum PSA level.
Penile and/or cutaneous metastases from prostate adenocarcinoma rarely  occur. Here, we detail the case of a 78-year-old man suffering from priapism  caused by metastatic prostate cancer with both penile and lower limb cutaneous  spread. His serum prostate-specific antigen level was 0.09 μg/L when  priapism developed. Corpora cavernosa biopsy was refused by the patient and  radical penectomy was performed. Postoperative pathologic and  immunohistochemical studies revealed undifferentiated prostate adenocarcinoma  cells growing in corpora cavernosa. Two months later, the patient presented  with multiple, erythematous nodules over the right lower leg. The  prostate-specific antigen level was found to be 0.264 μg/L. Biopsy of a  skin nodule revealed neoplastic cells consistent with metastatic prostate  adenocarcinoma. This is the first known case of metastatic prostate cancer  found in both penis and skin with a low serum prostate-specific antigen level.  Priapism presented as the initial clinical manifestation of metastatic  prostate cancer.
Department of Urology, The First Affiliated Hospital of the Medical College of Xi'an Jiaotong University, Xi'an, China.. dalinhexjtu@yahoo.com.cn
Dalin
D
He
Jin
J
Zeng
Xudong
X
Li
Kaijie
K
Wu
Dapeng
D
Wu
Hui
H
He
Wenbin
W
Song
Lei
L
Li
D000230:Adenocarcinoma / Q000556:secondary*; D000368:Aged; D017809:Fatal Outcome; D006801:Humans; D007866:Leg; D008297:Male; D010412:Penile Neoplasms / Q000556:secondary* / Q000601:surgery; D010413:Penis / Q000473:pathology / Q000601:surgery; D011317:Priapism / Q000209:etiology*; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011471:Prostatic Neoplasms / Q000473:pathology; D012878:Skin Neoplasms / Q000556:secondary*
D017430:Prostate-Specific Antigen