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| Year:
2026 |
Month:
April
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Volume:
15 |
Issue:
2 |
Page:
PC04 - PC06 |
Metastatic Prostatic Acinar Adenocarcinoma Presenting as a Penile Malignant Tumour: A Case Report
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Correspondence
Gwendolyn Fernandes, Kaustubh Vilasrao Kharche, Amey Rojekar,
Dr. Gwendolyn Fernandes
B2-801, Mahindra Vivante, Near Western Express Metro Station, Andheri (E),
Mumbai, Maharashtra, India.
E-mail: drgwenfern@yahoo.co.in :
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Penile metastasis from occult prostatic acinar adenocarcinoma is extremely rare and has been described in only a few case reports in the literature. The incidence of metastasis from known prostatic adenocarcinoma to the penis is less than 0.3%. The present case report involves a 72-year-old man presented with a hard penile mass measuring 2×1.5×1 cm for three months. He also reported lower urinary tract symptoms, two or three episodes of haematuria, anorexia, weight loss, and low back pain. A wedge biopsy of the penile mass was initially reported as adenosquamous carcinoma. Contrast-Enhanced Computed Tomography (CECT) revealed a heterogeneously enhancing, irregular distal penile lesion measuring 2×1.5×1 cm. Mild prostatomegaly measuring 36 cc was noted. Serum Prostate-Specific Antigen (PSA) level was 34 ng/mL. Three weeks later, the patient developed acute urinary retention, and the PSA level increased to 54 ng/mL. Total Penectomy and Transrectal Ultrasound (TRUS) guided biopsy of the prostate were performed. Histopathology revealed prostatic adenocarcinoma with a Gleason score of 8 (4+4), corresponding to Grade Group 4, while the penectomy specimen showed metastatic prostatic adenocarcinoma. Immunohistochemistry (IHC) demonstrated strong positivity for NK3 homeobox 1 (NKX3.1) and PSA, confirming the prostatic origin of the penile lesion. Unlike the present case, most reported patients with penile metastasis from prostatic adenocarcinoma have a known history of prostate cancer diagnosed years before the appearance of penile lesions. Presentation of occult prostatic carcinoma as a primary penile malignant tumour is highly unusual. Thorough clinical evaluation of the prostate in patients with genitourinary malignancies is therefore essential, particularly in the presence of elevated PSA levels.
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