Autopsy and Case Reports
Autopsy and Case Reports
Article / Autopsy Case Report

Intracardiac metastasis of squamous cell carcinoma of the penis

Sheila Aparecida Coelho Siqueira; Camila Satie Tomikawa

Downloads: 8
Views: 1210


Penile cancer shows variable incidence in different countries with a higher prevalence in developing countries. Squamous cell carcinoma represents the most common histologic type. The seventh decade of life corresponds to the mean age at diagnosis, but it is not an unusual diagnosis among young adults. Most cases present as “in situ” neoplasia or loco regional disease; however, systemic disseminated disease occurs via lymphatic and/or hematogeneous routes. The lymph nodes, liver, and lungs are the most frequently involved sites whereas the heart constitutes an exceptional and atypical site for penile cancer metastases. We report a case of a 79-year-old patient who presented a metastatic squamous cell carcinoma of the penis with intracardiac dissemination. The patient had a past history of cardiomyopathy, which required an artificial cardiac pacemaker implantation. He had been treated 1 year before with a partial penectomy but was admitted for emasculation due to the cancer relapse. During the postoperative period, he experienced sudden respiratory distress and died. The autopsy findings showed metastatic disease into the cardiac right chambers, pulmonary tumoral thrombi, and pulmonary hilar involvement. The authors call attention to the possibility of the presence of pacing leads, cardiomyopathy and the altered low blood flow in the right chambers, as predisposing factors for the tumoral seeding in this case.


Autopsy, Penile Neoplasms, Neoplasm Metastasis


Arya M, Kalsi J, Kelly J, Muneer A. Malignant and premalignant lesions of the penis. BMJ. 2013;346:f1149. [].

European Association of Urology. Online guidelines [Internet]. [place unknown]: European Association of Urology; 2012. Available from:" xmlns:xlink="" target="_blank" title="">">">

American Cancer Society. What are key statistics about penile cancer? [place unknown]; c2013 [cited 2013 May 29]. Available from:" xmlns:xlink="" target="_blank" title="">">">

Favorito LA, Nardi AC, Ronalsa M, Zequi SC, Sampaio FJ, Glina S. Epidemiologic study on penile cancer in Brazil. Int Braz J Urol. 2008;34:587-91. [].

Ebele JN, Sauter G, Epstein JI, Sesterhenn IA. Pathology and genetics of tumours of the urinary system and male genital organs. Lyon: IARC Press; 2004.

Hegarthy PK, Kayes O, Freeman A, Christopher N, Ralph DJ, Minhas S. A prospective study of 100 cases of penile cancer managed according to European Association of Urology guidelines. BJU Int. 2006;98:526-31. [].

Neuzillet Y, Méjean A, Lebret T. [Rare locations of metastases from penile cancer]. Prog Urol. 2008;18(Suppl 7):396-8. French. []10.1016/S1166-7087(08)74573-1

Dillner J, von Krogh G, Horenblas S, Meijer CJ. Etiology of squamous cell carcinoma of the penis. Scand J Urol Nephrol Suppl. 2000;205:189-93. [].

Maden C, Sherman KJ, Beckmann AM, et al. History of circumcision, medical conditions, and sexual activity and risk of penile cancer. J Natl Cancer Inst. 1993;85:19-24. [].

Miralles-Guri C, Bruni L, Cubilla AL, Castellsagué X, Bosch FX, de Sanjosé S. Human papillomavirus prevalence and type distribution in penile carcinoma. J Clin Pathol. 2009;62:870-8. [].

Chaux A, Reuter V, Lezcano C, Velazquez E, Codas R, Cubilla AL. Autopsy findings in 14 patients with penile squamous cell carcinoma. Int J Surg Pathol. 2011;19:164-9. [].

Borsaru AD, Lau KK, Solin P. Cardiac metastasis: a cause of recurrent pulmonary emboli. Br J Radiol. 2007;80:e50-3. [].

Prichard RW. Tumors of the heart: review of the subject and report on 150 cases. Arch Pathol. 1951;51:98-128.

Gassman HS, Meadows R Jr, Baker LA. Metastatic tumors of the heart. Am J Med. 1955;19:357-65. [].

Lam KY, Dickens P, Chan ACL. Tumors of the heart: a 20 year experience with a review of 12485 consecutive autopsies. Arch Pathol Lab Med. 1993;117:1027-31.

Shapiro LM. Cardiac tumours: diagnosis and management. Heart. 2001;85:218-22. [].

Butany J, Leong SW, Carmichael K, Komeda M. A 30-year analysis of cardiac neoplasms at autopsy. Can J Cardiol. 2005;21:675-80.

Mukai K, Shinkai T, Tominaga K, Shimasato Y. The incidence of secondary tumors of the heart and pericardium: a 10-year study. Jpn J Clin Oncol. 1988;18:195-201.

Sutsch G, Jenni R, Von Segesser L, Schneider J. Heart tumours: incidence, distribution, diagnosis. Exemplified by 20,305 echocardiographies. Schweiz Med Wochenschr. 1991;121:621-9.

Byun SW, Park ST, Ki EY, et al. Intracardiac metastasis from known cervical cancer: a case report and literature review. World J Surg Oncol. 2013;11:107. [].

Liao JN, Chen IM, Yang AH, Yu WC. A primary cardiac sarcoma spreading along the pacing leads of a permanent pacemaker. J Am Coll Cardiol. 2012;59:1487. [].

Magomedov MK. [Metastasis of squamous cell carcinoma of the penis into the heart]. Arkh Patol. 1998;60:59-61. Russian. PMid:9612515.

Swierz J, Poznański J, Stawarz B. [Metastasis of penile cancer to the heart in a 20-year-old patient]. Wiad Lek. 1992;45:314-6. Polish. PMid:1462597.

Portero JN, Pardo FL, Pérez RC. Massive intracardiac metastases secondary to squamous cell carcinoma located at the level of the penis. Int J Cardiol. 2008;127:e96-7. [].

Théodore C, Androulakis N, Spatz A, Goujard C, Blanchet P, Wibault P. An explosive course of squamous cell penile cancer in an AIDS patient. Ann Oncol. 2002;475-9. [].


Publication date:

569696ac64cc8b5cda711bda autopsy Articles

Autops Case Rep

Share this page
Page Sections