Department of Urology, MacKay Memorial Hospital, No.92, Sec. 2, Zhongshan N. Rd., Zhongshan Dist, Taipei City, 10449, Taiwan.
Department of Pathology, Tamsui branch, MacKay Memorial Hospital, No.45, Minsheng Rd., Tamsui Dist, New Taipei City, 25160, Taiwan.
BMC Urol. 2019 Sep 2;19(1):81. doi: 10.1186/s12894-019-0511-3.
Metastatic tumors of the penis are uncommon, and fewer than 500 cases have been reported since 1870. Most penile secondary tumors originate in organs of the genitourinary tract, followed by the gastrointestinal tract. Primary tumors of sarcoma origin are extremely rare. Herein, we present a teenager who had recurrent sarcoma of the right femur with penile metastasis.
The 20-year-old male patient was diagnosed with sarcoma of the right femur when he was 16 days old. He was stable following combination chemotherapy with the VAC regimen (vincristine, adriamycin, and cyclophosphamide) and debulking surgery. In January 2018, five months ago, he presented with right leg pain and swelling, and a recurrent tumor was found. Following excision of the tumor showed recurrent sarcoma. However, 2 months after the operation, right thigh swelling with tenderness occurred. A firm nodule on the glans of the penis was also noted. Penile metastasis was suspected and a biopsy was performed. The final pathology report disclosed pleomorphic sarcoma with penile metastasis. Symptoms including priapism and inguinal lymph node enlargement progressed rapidly within 2 weeks. He also complained of voiding difficulty with urine retention. The patient died 35 days after admission due to pneumonia with septic shock.
Penile metasitasis largely occurs from organs in the pelvis. To the best of our knowledge, this is the first case of a teenager with a secondary penile tumor, metastasizing from sarcoma of the bone. It presented as a palpable mass, and then progressed into priapism. The patient had a dismal prognosis and the symptoms progressed faster than his physicians anticipated.
阴茎转移性肿瘤并不常见，自 1870 年以来，报告病例少于 500 例。大多数阴茎继发性肿瘤起源于泌尿生殖系统器官，其次是胃肠道。肉瘤来源的原发性肿瘤极为罕见。在此，我们报告了一例复发性右股骨肉瘤合并阴茎转移的青少年患者。
这名 20 岁男性患者在 16 天大时被诊断为右股骨肉瘤。他接受 VAC 方案（长春新碱、阿霉素和环磷酰胺）联合减瘤手术的联合化疗后病情稳定。2018 年 1 月，也就是 5 个月前，他出现右下肢疼痛和肿胀，发现复发性肿瘤。肿瘤切除后显示复发性肉瘤。然而，术后 2 个月，出现右大腿肿胀伴压痛。还注意到阴茎龟头有一个硬结。怀疑为阴茎转移，并进行了活检。最终病理报告显示为多形性肉瘤伴阴茎转移。在 2 周内，包括阴茎异常勃起和腹股沟淋巴结肿大在内的症状迅速进展。他还主诉排尿困难伴尿潴留。入院后 35 天，患者因肺炎合并感染性休克死亡。
阴茎转移主要发生在骨盆内的器官。据我们所知，这是首例青少年骨源性肉瘤的继发性阴茎肿瘤，表现为可触及的肿块，随后进展为阴茎异常勃起。患者预后极差，症状进展速度超出了医生的预期。
