CASE REPORT article
Front. Oncol.
Sec. Genitourinary Oncology
This article is part of the Research TopicApproaches and Advances in Urologic Cancer EpidemiologyView all 9 articles
Penile Involvement Associated with Renal Pelvic Squamous Cell Carcinoma: A Case Report and Mechanistic Considerations
Provisionally accepted
Kotaro Masaki
Takuya Tsujino*Hiroyuki OkadaYuki Yoshikawa
Ryoichi MaenosonoYusaku ImuraMasashi SanadaKensuke HirosunaYuta FurusawaRei YoshimiIssei KojimaMoritoshi SakamotoKengo IwatsukiYuki NakajimaTakuya MatsudaTakuya HigashioShuya TsuchidaShogo YamazakiKo NakamuraTatsuo FukushimaKazuki NishimuraKeita Nakamori
Takeshi TsutsumiTomohisa MatsunagaHaruhito Azuma- Department of Urology, Osaka Medical College, Takatsuki, Japan
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Background :Squamous cell carcinoma (SCC) of the renal pelvis is an uncommon malignancy, accounting for less than 1% of upper urinary tract tumors. Penile metastasis from renal pelvic SCC has not been documented. Case presentation: A 74-year-old man presented with a firm penile nodule. Magnetic resonance imaging (MRI) demonstrated an intracavernosal mass, while contrast-enhanced CT revealed a large left renal pelvic tumor (89 mm) with hepatic, and hilar lymph-node metastases, without pelvic or inguinal lymphadenopathy. Histopathological examination of both the renal pelvic and penile lesions showed keratinizing SCC. Immunohistochemistry demonstrated diffuse p40 and p63 positivity with PAX8 and p16 negativity, supporting a urothelial-tract origin rather than a primary penile carcinoma. Given the disseminated disease and rapid clinical deterioration, no systemic or surgical therapy was undertaken, and best supportive care was provided. Conclusion: This case constitutes, to our knowledge, the first reported instance of penile involvement most consistent with metastatic renal pelvic. In patients with advanced upper urinary tract malignancy who develop penile lesions, secondary involvement should be considered. The absence of regional lymphadenopathy and the disseminated pattern suggest a hematogenous retrograde venous dissemination pathway.
Keywords: case report, Pelvic cancer, Penile metastasis, retrogradevenous spread, Squamous cell carcinoma
Received: 09 Dec 2025; Accepted: 16 Feb 2026.
Copyright: © 2026 Masaki, Tsujino, Okada, Yoshikawa, Maenosono, Imura, Sanada, Hirosuna, Furusawa, Yoshimi, Kojima, Sakamoto, Iwatsuki, Nakajima, Matsuda, Higashio, Tsuchida, Yamazaki, Nakamura, Fukushima, Nishimura, Nakamori, Tsutsumi, Matsunaga and Azuma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Takuya Tsujino
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