Atypical Phimosis Secondary to a Preputial Metastasis from Rectal Carcinoma

Background: Cutaneous metastases from colorectal cancer are uncommon, accounting for 6.5% of all secondary skin lesions. They occur in advanced disease. The most common site is the abdomen. The penis is a rare site. Case Report: We report the case of a 79-year-old patient who presented, two years after rectocolectomy for a rectal adenocarcinoma, obstructive renal failure secondary to a presacral recurrence, as well as symptomatic phimosis associated with papulonodules invading the penis, scrotum and pubis. After hemodialysis, percutaneous pyelostomy, and double-J catheter placement, the patient underwent circumcision and a pubic skin biopsy. On histology and immunohistochemistry, a cutaneous metastasis originating from the rectal adenocarcinoma was diagnosed. Conclusions: Penile invasion by colorectal cancer revealed by phimosis is a rare occurrence but needs to be recognized and promptly diagnosed by biopsy in order to propose appropriate adjuvant therapy. These rare lesions can occur without any liver or lung involvement.

[1]  P. Kelemen,et al.  Unusually large colon cancer cutaneous and subcutaneous metastases occurring in resection scars. , 2005, Dermatology online journal.

[2]  Connie A. Keehn,et al.  Cutaneous metastasis: a clinical, pathological, and immunohistochemical appraisal , 2004, Journal of cutaneous pathology.

[3]  I. Bain,et al.  Colonic adenocarcinoma presenting as a cutaneous metastasis in an old operative scar. , 2003, Journal of postgraduate medicine.

[4]  I. Orengo,et al.  Cutaneous Metastasis: A Meta-Analysis of Data , 2003, Southern medical journal.

[5]  Cohen Np,et al.  Penile metastasis: an unusual presentation of metastatic colonic cancer. , 2002 .

[6]  N. McLean,et al.  Cutaneous metastasis to the head and neck from colonic carcinoma. , 2000, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.

[7]  F. Al-Mashat,et al.  Penile metastasis from rectal carcinoma. , 2000, Saudi medical journal.

[8]  H. Nelson,et al.  Wound recurrence following conventional treatment of colorectal cancer , 1996, Diseases of the colon and rectum.

[9]  Barrows Gh,et al.  Cutaneous metastasis of colon carcinoma: a case report. , 1993 .

[10]  D. Kapp,et al.  Cancer metastatic to the penis: treatment with hyperthermia and radiation therapy and review of the literature. , 1992, Journal of Urology.

[11]  J. Kral,et al.  An unusual presentation of colon cancer , 1986, Journal of surgical oncology.

[12]  J. Gottlieb,et al.  Cutaneous metastases from carcinoma of the colon. , 1970, JAMA.

[13]  A. Paquin,et al.  Secondary carcinoma of the penis. A review of the literature and a report of nine new cases , 1956, Cancer.

[14]  H. Takenaka,et al.  The solitary cutaneous metastasis of asymptomatic colon cancer to an operative scar , 2004, Surgery Today.

[15]  G. Banerjee,et al.  Penile metastasis: an unusual presentation of metastatic colonic cancer. , 2002, Journal of the Royal College of Surgeons of Edinburgh.

[16]  G. Barrows,et al.  Cutaneous metastasis of colon carcinoma: a case report. , 1993, Connecticut medicine.

[17]  J. Dekernion,et al.  Metastatic carcinoma to penis: when is total penectomy indicated? , 1987, Urology.