Abstract
Prostate cancer with penile metastasis is exceedingly rare. We report a synchronous metastatic hormone-sensitive prostate cancer presenting initially as a penile lesion in a 70-year-old male. Penile tumor excision confirmed prostate adenocarcinoma by immunohistochemistry. MRI revealed prostate enlargement without lymph node involvement; biopsy indicated Gleason Score 3 + 3 adenocarcinoma, and bone scan showed pubic bone metastasis. Initial PSA was significantly elevated (318 ng/ml). Androgen deprivation therapy led to progressive PSA decline and good clinical response. Aggressive surgical intervention for penile metastasis is discouraged due to limited benefits and potential deterioration in quality of life.