Introduction: Penile metastasis from prostate cancer is an extremely rare finding (estimated incidence < 0.3 %). Diagnosis usually occurs in advanced stages; however, PSMA-PET imaging has enabled the early detection of atypical and asymptomatic recurrences.
Case report: A 60-year-old man, diagnosed in 2013 with prostate adenocarcinoma, initially treated with external beam radiotherapy. During follow-up, he developed biochemical recurrence with a PSA of 1.04 ng/mL. In 2023, an 18F-PSMA PET/CT revealed a 1.1 cm nodular lesion at the right penile base (SUVmax 3.47), consistent with early metastasis. Exclusive systemic therapy with leuprolide acetate and enzalutamide was initiated, achieving a sustained PSA decrease to 0.12 ng/mL and complete resolution of pathological uptake on PET-PSMA in 2024.
Conclusion: This case highlights the role of PSMA-PET in the early detection of atypical metastases and demons- trates that exclusive systemic therapy can achieve complete metabolic response in selected patients with oligometastatic, low-volume disease.
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Revista Científica
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