Malignant priapism as the presenting manifestation of penile metastasis following radical cystoprostatectomy for bladder urothelial carcinoma: a case report.

Penile metastasis is a rare but grave complication of systemic malignancies, occasionally manifesting as malignant priapism due to neoplastic infiltration of the corpora cavernosa. We report a 59-year-old male who presented with painful, refractory penile erection 3 years after radical cystoprostatectomy for bladder urothelial carcinoma (pT3bN0M0). Pelvic magnetic resonance imaging revealed a heterogeneous infiltrative mass involving the proximal corpora cavernosa bilaterally. 18F-fluorodeoxyglucose positron emission tomography/computed tomography confirmed multiple metabolically active penile lesions without distant metastasis. Core needle biopsy established the diagnosis of metastatic transitional cell carcinoma. Total penectomy was performed, and adjuvant chemotherapy was recommended. This case highlights the importance of clinical vigilance in urological malignancy survivors.