Nasrallah Oussama G, Fawaz Mohammad W, Mahdi Jana H, Armache Alexandre K, El Sayegh Noura, Nasr Rami W
Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.
Int J Surg Case Rep. 2024 Sep;122:110078. doi: 10.1016/j.ijscr.2024.110078. Epub 2024 Jul 25.
Colorectal cancer is the second most common cause of death worldwide and may present as metastatic disease involving the liver, lungs and bones, and pelvic organs. Penile and scrotal metastasis may occur secondary to primary tumors originating from the genito-urinary tract.
We present a case of rectal adenocarcinoma metastatic to the penis and scrotum s/p chemotherapy and radiotherapy. His metastatic involvement was complicated by infections, necrosis and growth of maggots. Patient underwent wide excision and debridement of the metastatic deposits in the pubic, penile, scrotal and perineal region in addition to split-tissue skin graft from the right anterior thigh to cover the pubic region, the remainder of the penile shaft, and the scrotum.
Peno-scrotal metastasis secondary to rectal adenocarcinoma is a rare condition. It may present as malignant priapism, hematuria, obstructive urinary symptoms occurring when there is urethral involvement. The mechanism of metastasis may be due to retrograde venous flow from the vesical, pudendal, hemorrhoidal plexuses, and the prostatic venous plexus draining the cavernosal veins of the penis. Additionally, lymphatic involvement and spread may play an important role in the spread of the disease. Treatment of such conditions relies on chemotherapy and radiotherapy and surgery for local control and symptomatic treatment.
This article describes the rare occurrence of peno-scrotal metastasis of rectal adenocarcinoma and provides an overview on diagnosis, etiology, and management of the disease.
结直肠癌是全球第二大常见死因，可能表现为转移性疾病，累及肝脏、肺、骨骼及盆腔器官。阴茎和阴囊转移可能继发于泌尿生殖道原发肿瘤。
我们报告一例经化疗和放疗后直肠腺癌转移至阴茎和阴囊的病例。其转移灶并发感染、坏死及蛆虫滋生。患者除接受广泛切除及清创处理耻骨、阴茎、阴囊和会阴区域的转移灶外，还接受了取自右大腿前侧的分叶组织皮肤移植，以覆盖耻骨区域、阴茎体其余部分及阴囊。
直肠腺癌继发阴茎阴囊转移是一种罕见情况。其表现可能为阴茎异常勃起、血尿，尿道受累时出现梗阻性尿路症状。转移机制可能是由于来自膀胱、阴部、痔静脉丛及引流阴茎海绵体静脉的前列腺静脉丛的逆行静脉血流。此外，淋巴受累及扩散可能在疾病传播中起重要作用。此类疾病的治疗依赖化疗、放疗及手术以实现局部控制和对症治疗。
本文描述了直肠腺癌阴茎阴囊转移的罕见病例，并对该疾病的诊断、病因及管理进行了概述。
