Metastatic cancer of the bladder to the penis — a report of three cases and a literature review

Abstract

Over the course of nine years three patients with penile metastasis seeding from a primary bladder cancer were treated at our centre. Penile metastatic disease is generally thought of as a poor prognostic indicator and most patients die within a year of their diagnosis. Survival of our patients following diagnosis ranged from six to sixteen months which is comparable to the average described in the literature. In two of our patients, penile metastasis was the first sign of cancer spread and importantly they were largely asymptomatic until this time. This should prompt clinicians to consider penile metastasis in their review of bladder patients. Patients should also be made aware of the various presenting symptoms. Early recognition of a penile metastasis would lead to the faster implementation of treatments thereby improving a patient’s quality of life. As metastasis to the penis has a low incidence a causal understanding and defined palliative treatments remain uncertain in this group of patients. Depending on the type and severity of the primary tumour, symptoms secondary to the lesions and the patient’s general condition, surgical removal of the lesion by total or partial resection of the penis, and possible ureterostomia, palliative radiotherapy and chemotherapy all remain treatment options to be considered. In cases of severe pain difficult to control by other means, the dorsal penile nerve may be removed.