CUTANEOUS PENILE AND SCROTAL METASTASES FROM RECTAL ADENOCARCINOMA - CASE REPORT AND LITERATURE REVIEW

Penile and scrotal metastases from rectal adenocarcinoma are rare and usually indicate advanced disease with poor prognosis. We report a 59-year-old male with locally advanced rectal cancer presenting with rectal bleeding. Imaging revealed a circumferential distal rectal tumor with extensive mesorectal, iliac, and inguinal lymphadenopathy. Elevated CEA and CA 19-9 were noted. The patient underwent neoadjuvant treatment. Twelve weeks later, multiple nodular and ulcerative lesions appeared on the penis, scrotum, inguinal region, and mons pubis. Skin biopsy confirmed metastatic rectal adenocarcinoma. Palliative colostomy was performed due to intestinal obstruction, but the patient died shortly after. Retrograde venous and lymphatic spread were likely mechanisms of metastasis. No standardized treatment exists; management is largely palliative. This case highlights an atypical and aggressive metastatic pattern of rectal adenocarcinoma. Awareness of cutaneous penoscrotal metastases is crucial, although the prognosis remains poor. Key words: rectal adenocarcinoma, penile metastasis, scrotal metastasis, surgery.