Rectal adenocarcinoma infiltrating the bulbar urethra and metastasising to the penis.
Secondary penile tumours from rectal carcinoma is a known clinical entity but can be missed unless carefully evaluated. We report a case of rectal adenocarcinoma with synchronous painless penile nodules. A patient presented with constipation and rectal bleeding. He had an anorectal growth as well as palpable nodules on his penis. Rectal biopsy yielded adenocarcinoma. Imaging revealed direct infiltration of tumour into the bulb of the penis as well as distal shaft lesions. Fine-needle aspiration cytology of the penile nodule showed metastatic adenocarcinoma. Diversion colostomy was performed and the patient referred for chemoradiation. Since he did not have any urinary symptoms, the penile lesions were left unaltered. Repeat imaging after concurrent chemoradiotherapy showed no response. The prognosis was explained and the patient was given palliative clinic care.
Department of General Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Puducherry, India.
Mathews
M
James
Department of General Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Puducherry, India.
Anandhi
A
Amaranathan
Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, Puducherry, India.
Vishnu Prasad
VP
Nelamangala Ramakrishnaiah
Department of Pathology, JIPMER, Puducherry, Puducherry, India.
Pampa Chakrabarty
PC
Toi
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000175:diagnosis*; D010412:Penile Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy; D010413:Penis / Q000473:pathology; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000628:therapy; D014521:Urethra / Q000473:pathology*