Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2022; 10(31): 11658-11664
Published online Nov 6, 2022. doi: 10.12998/wjcc.v10.i31.11658
Metachronous isolated penile metastasis from sigmoid colon adenocarcinoma: A case report
Guo-Lin Yin, Jiang-Bo Zhu, Cheng-Lin Fu, Ru-Liang Ding, Jun-Miao Zhang, Qian Lin
Guo-Lin Yin, Jiang-Bo Zhu, Jun-Miao Zhang, Qian Lin, Department of Urology, Taizhou First People's Hospital, Taizhou 318020, Zhejiang Province, China
Cheng-Lin Fu, Department of Pathology, Taizhou First People's Hospital, Taizhou 318020, Zhejiang Province, China
Ru-Liang Ding, Department of Anorectology, Taizhou First People's Hospital, Taizhou 318020, Zhejiang Province, China
Author contributions: Yin GL and Lin Q wrote the manuscript and collected the data; Zhu JB, Fu CL and Zhang JM collected the data; Ding RL contributed to the project development; All authors have read and approve the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qian Lin, MD, Chief Doctor, Chief Physician, Department of Urology, Taizhou First People's Hospital, No. 218 Hengjie Road, Huangyan District, Taizhou 318020, Zhejiang Province, China. linqian_2004@163.com
Received: August 20, 2022
Peer-review started: August 20, 2022
First decision: September 19, 2022
Revised: September 24, 2022
Accepted: October 17, 2022
Article in press: October 17, 2022
Published online: November 6, 2022
Processing time: 67 Days and 14.9 Hours
Abstract
BACKGROUND

Sigmoid colon adenocarcinoma has a high incidence among gastrointestinal tumors, and it very rarely metastasizes to the penis. The literature reports that the prognosis after penile metastasis is generally poor, with a median survival of about 9 mo. Metachronous isolated metastasis to the penis originating from sigmoid colon adenocarcinoma has not been reported so far. Here, we report a case of sigmoid colon adenocarcinoma with isolated penile metastasis occurring 2 years after surgery. The mass was pathologically confirmed as metastatic adenocarcinoma, and oral chemotherapy with capecitabine was given after surgery. The tumor did not recur during the 2-year follow-up period.

CASE SUMMARY

A 79-year-old man presented to the urology department with "a mass located at the root of the penis since 1 mo". Enhanced computed tomography (CT) examination suggested a 12 mm × 10 mm × 9 mm nodule at the root of the right penile corpus cavernosum. Cranial, pulmonary, and abdominal CT; and bone scan did not show any tumorigenic lesions. The carcinoembryonic antigen (CEA) level was slightly elevated (6.01 ng/mL, reference value 0-5 ng/mL). The patient had undergone laparoscopic radical sigmoidectomy for sigmoid colon cancer 2 years ago. The postoperative pathology showed moderately differentiated adenocarcinoma of the sigmoid colon, and the stage was PT2N0M0. The penile mass was removed under general anesthesia. The postoperative pathology showed adenocarcinoma, and immunohistochemistry showed CDX2(+), CK20(+), and Villin(+). Based on the medical history, he was diagnosed with penile metastasis from sigmoid colon adenocarcinoma. The CEA level returned to normal (3.34 ng/mL) 4 d after surgery. Oral chemotherapy with capecitabine was given subsequently, and tumor recurrence was not found during the 2-year follow-up period.

CONCLUSION

To our knowledge, this is a rare case of metachronous isolated penile metastasis from sigmoid colon adenocarcinoma. The penis is a potential site of metastasis of colon adenocarcinoma, and the possibility of metastasis should be considered in patients with a history of colon cancer who present with a penile mass. Solitary penile metastasis can be removed surgically, in combination with chemotherapy, and it may have good long-term outcomes.

Keywords: Colon adenocarcinoma; Penis; Metastases; Metachronous; Adenocarcinoma; Case report

Core Tip: Sigmoid colon adenocarcinoma has a high incidence among gastrointestinal tumors, and it very rarely metastasizes to the penis. The presence of penile metastases usually indicates the late stage of disease and a poor prognosis. We report a rare case of metachronous isolated penile metastasis from sigmoid colon adenocarcinoma, which was confirmed by pathology and immunohistochemistry. Surgical resection of penile metastases combined with subsequent chemotherapy may yield good long-term outcomes.