Metastatic castrate-resistant prostate cancer to the penis resulting in malignant priapism and urethral obstruction

Courtney Stewart; Joon Yau Leong; W Kevin Kelly; Mihir S Shah

doi:10.1016/j.eucr.2026.103380

Metastatic castrate-resistant prostate cancer to the penis resulting in malignant priapism and urethral obstruction

Urol Case Rep. 2026 Feb 16:65:103380. doi: 10.1016/j.eucr.2026.103380. eCollection 2026 Mar.

Authors

Courtney Stewart¹, Joon Yau Leong¹, W Kevin Kelly², Mihir S Shah¹

Affiliations

¹ Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA.
² Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA.

Abstract

A 76-year-old male with metastatic castrate-resistant prostate cancer was found to have metastatic disease to the urethra and penis on PSMA PET scan. This resulted in constant pain due to obstruction of blood flow through the corpora cavernosum resulting in priapism and urethral obstruction. The patient underwent a radical penectomy, partial urethrectomy and perineal urethrostomy creation. Final pathology confirmed metastatic prostatic adenocarcinoma. Although rare, prostate cancer can metastasize to the corpora spongiosum or cavernosa. Treatment options are limited, and surgical excision with urinary diversion is likely to provide the most durable outcomes for one's quality of life.

Keywords: Castrate-resistant prostate cancer; Malignant priapism; Malignant urethral obstruction; Metastatic prostate cancer; Priapism.

Publication types

Case Reports