Penile Metastasis as the First Manifestation of Sarcomatoid Renal Cell Carcinoma

A 51-year-old male patient without any history of a systemic disease was admitted to the urology department with the complaints of terminal hematuria and a penile mass. Physical examination confirmed the presence of a mass in the penile shaft and the patient was referred for magnetic resonance imaging (MRI) examination. On abdominal MRI, a 70-mm sized, well-circumscribed, heterogeneous, enhancing mass lesion was detected in the interpolar region of the right kidney and interpreted as renal cell carcinoma (RCC) (Figure 1). MRI also revealed a mass lesion infiltrating a long segment of the corpus spongiosum in the penile shaft and a few millimeters sized similar mass lesions in the corpus cavernosum (Figure 2). The patient underwent radical nephrectomy for the renal mass and excisional biopsy was performed from the corpus cavernosum. The histopathological diagnosis was consistent with Fuhrman grade IV RCC showing sarcomatoid features and penile metastasis. The patient was referred to the medical oncology department for sunitinib treatment.