Surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy of rectal adenocarcinoma with penile metastasis - a case report

Sep 24, 2026

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Case report describing metastatic rectal adenocarcinoma to the penis, an exceptionally rare event despite the pelvic region’s vascular proximity. A 59-year-old Chinese man developed penile pain and dysuria 6 months before presentation; immunohistochemical analysis after total penectomy supported rectal origin. Treatment combined surgery, chemotherapy, radiotherapy, targeted therapy, and immunotherapy, with survival for 4 years and 6 months after penectomy, despite late metastasis and subsequent treatment-related complications leading to death. Literature review and conclusions emphasize persistently poor overall prognosis and potential value of strategic multimodal therapy in select limited penile involvement.

LanguageEnglish

CategoryHealthcare

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Pages11

Reading Time28 min

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Surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy of rectal adenocarcinoma with penile metastasis: a case report Zhanyu Wang1, Jiahui Shan2, Xinjie Zhou2, Jianwei Wang1, Guangyang Yu 1, Wei Dong1, Fei Huai 1, Qi Sun1, Guoliang Lu1, Zhenzhen Ma1, Hechen Liu1 1Department of Urology, Shandong Second Provincial General Hospital, Jinan, China; 2Department of Medicine, Qingdao University, Qingdao, China Contributions: (I) Conception and design: Z Wang; (II) Administrative support: Z Ma, H Liu; (III) Provision of study materials or patients: J Wang, G Yu, W Dong, F Huai, Q Sun, Z Wang; (IV) Collection and assembly of data: G Lu, Z Wang, J Shan, X Zhou; (V) Data analysis and interpretation: Z Wang, J Shan, X Zhou, H Liu; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Hechen Liu. Department of Urology, Shandong Second Provincial General Hospital, Jinan, China. Email: [liuhechen_0828@163.com](liuhechen_0828@163.com). Background: Despite the rich proximity and vascularization to the pelvic organs, metastatic lesions to the penis are incredibly uncommon. Most primary tumors are genitourinary cancers, and rectal origins are rare. Only 56 cases of metastatic penile tumors have been reported since 1870. Several palliative or curative methods, such as chemotherapy, total penectomy, and radiotherapy, have been applied to treat this condition in previous cases; however, the patient prognosis is poor. Immunotherapy is a beneficial treatment approach for multiple cancers, and recent investigations have shown that it may be beneficial for patients with advanced penile cancer. Case Description: Herein, we report the case of a 59-year-old Chinese man who had metastatic adenocarcinoma in the penile tissue 3 years after rectal cancer resection. The patient presented with penile pain and dysuria for 6 months when he was 54 years old, and Immunohistochemical staining showed that the origin was the rectum after total penectomy. The patient received surgery, chemotherapy, radiotherapy, targeted therapy and immunotherapy positively and still survived for a further 4 years and 6 months following penectomy despite the late metastasis of rectal cancer. There are two major changes and progress after penectomy, all of which have undergone surgical treatment during continuous treatment and followup, the patient completed right inguinal lymphadenectomy when his right regional nodes metastasis was found 23 months after penectomy. While the patient suffered from radiation injury after 47 months after penectomy, which led to radiation necrosis and hip soft tissue infection, and the patient tended to lay prone instead oflying on the back because of the hip pain. The patient ultimately died of multiple organ failure. Conclusions: All of the previously reported cases of penile metastasis from rectal cancer since 1870 have been reviewed. Yet, the metastatic prognosis remains poor regardless of the treatment options, except for lesions where metastasis is only limited to the penis. We found that the patient may derive more benefit from strategic therapies including surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy. Keywords: Metastatic rectal adenocarcinoma; penile metastasis; case report; prognosis; treatment Submitted Nov 22, 2022. Accepted for publication Apr 23, 2023. Published online Apr 27, 2023. doi: 10.21037/jgo-23-84 View this article at: [https://dx.doi.org/10.21037/jgo-23-84](https://dx.doi.org/10.21037/jgo-23-84) © Journal of Gastrointestinal Oncology. All rights reserved. J Gastrointest Oncol 2023;14(2):1155-1165 | [https://dx.doi.org/10.21037/jgo-23-84](https://dx.doi.org/10.21037/jgo-23-84) 1156 Wang et al. Rectal adenocarcinoma with penile metastasis Introduction The penis is an uncommon site of metastatic colorectal adenocarcinoma (1) . The first reported case of penile metastases from rectal adenocarcinoma was re

FAQs

Why are penile metastases from rectal adenocarcinoma considered rare?

The document notes that, despite the proximity and vascularization of pelvic organs, metastatic lesions to the penis are incredibly uncommon, and rectal origins are rare.

How was the metastatic origin determined after surgery?

After total penectomy, immunohistochemical staining indicated that the penile lesion originated from the rectum.

What treatments were used and what outcome was reported?

The patient received surgery, chemotherapy, radiotherapy, targeted therapy, and immunotherapy, surviving an additional 4 years and 6 months after penectomy, although death ultimately occurred due to multiple organ failure.

Sep 24, 2026

Uploaded by Rowan