A Case of Malignant Priapism Secondary to Muscle Invasive Bladder Cancer and Review of Palliative Management

TL;DR

A 72-year-old man with bladder cancer developed a rare condition called malignant priapism, and the paper discusses its diagnosis and a new approach to managing it.

Contribution

The paper introduces a three-tiered approach for managing malignant priapism not covered by current guidelines.

Findings

Malignant priapism can occur as a late complication of muscle-invasive bladder cancer.

Penile exploration and biopsy confirmed high-grade urothelial carcinoma invading the corporal tissues.

A three-tiered management strategy was proposed for this rare condition.

Abstract

Malignant priapism secondary to a genitourinary malignancy is a rare and late-stage oncological finding. A 72-year-old man with a past medical history of muscle-invasive bladder cancer treated with trimodal therapy presented with altered mental status, white discharge from his Foley catheter, and bilateral corporal rigidity. Initial pelvic magnetic resonance imaging demonstrated engorgement of the corporal bodies without obvious tumor invasion. The patient eventually underwent penile exploration and bilateral decompression, and a biopsy revealed high-grade urothelial carcinoma invading the corporal tissues. Despite current guidelines for priapism, we present a three-tiered approach to the management of malignant priapism.

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