Penoscrotal lymphedema associated with metastatic renal cell carcinoma.
A 64-year-old male presented with lower back pain, radiating in a sciatic-type distribution, swelling in his lower abdomen and right leg, and edema of the scrotum and penile shaft. A sonogram and CT imaging indicated an enhancing mass in the right kidney and a spinal metastasis. The right lower extremity and penoscrotal lymphedema was caused by lymphatic obstruction due to a sacral metastasis of renal cell carcinoma. He was treated with cytoreductive nephrectomy, radiation and a systemic tyrosine kinase inhibitor. Pelvic imaging is suggested to determine whether malignant lymphatic obstruction is present when presented with idiopathic penoscrotal edema.
Urology Division, Hartford Healthcare Medical Group, Hartford, Connecticut, USA.
David
D
Crawley
Peter
P
Haddock
Max
M
Jackson
Jeffrey
J
Kamradt
Stuart
S
Kesler
D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging* / Q000556:secondary; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D035002:Lower Extremity; D008209:Lymphedema / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010409:Penile Diseases / Q000209:etiology*; D012447:Sacrum / Q000000981:diagnostic imaging*; D012611:Scrotum; D013125:Spinal Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging* / Q000556:secondary; D014057:Tomography, X-Ray Computed