Metastatic intrigue: Penile involvement in prostate cancer with neuroendocrine differentiation—A case report

Abstract

Background: Neuroendocrine carcinoma of the prostate is a rare tumor subtype found in the spectrum of prostate cancer, and is more difficult to detect, due to the low prostate-specific antigen values associated with it. A high degree of suspicion is hence needed to arrive at the diagnosis in such cases. Even rarer is the presentation of this subtype with metastasis to the penis.

Case Presentation: A 61-year-old South Asian gentleman presented with a penile swelling which, on evaluation with prostate-specific membrane antigen positron emission tomography-computed tomography and fine-needle aspiration cytology, turned out to be metastatic involvement from neuroendocrine-prostate cancer. The patient received a combination of pelvic radiotherapy, androgen deprivation therapy (ADT) and chemotherapy which led to a resolution in the penile lump, but subsequent rapid renal metastasis ensued and second-line chemotherapy was instituted.

Conclusion: Our case illustrates an extraordinary presentation of neuroendocrine prostate cancer with penile metastasis and urinary retention, showcasing the efficacy of radiotherapy and ADT, but also rapid progression to the viscera, underscoring the complexity of this malignancy.

Keywords

carcinoma / neuroendocrine / penile / prostate

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The Author(s). UroPrecision published by John Wiley & Sons Australia, Ltd on behalf of Higher Education Press.