Secondary malignancies of the penis and epididymis: a case report and review of the literature.

A patient with carcinoma of the colon developed metastases to the penis and right epididymis. These two organs are rare locations for metastases and the concurrent involvement of both sites has not been previously described. Our patient and the results of a literature review are presented. Two hundred eighteen cases of penile and 37 separate cases of epididymal metastases were identified. The genitourinary and gastrointestinal tracts were the predominant sites of the primary malignancies. Presenting symptoms, the interval between diagnoses of the primary and metastatic lesions, and the therapy of the penile/epididymal deposits varied greatly. Surgical excision is the major mode of therapy; radiotherapy, chemotherapy, or hormonal therapy may be beneficial in selected cases. Survival among these patients is poor due to the presence in most patients of widespread metastases in addition to their genital lesions. However, instances of prolonged survival are noted in both groups. Patient characteristics and possible mechanisms of metastatic spread to the genitals are discussed.