A Rare Case of Penile Metastases as a Harbinger of Primary Pulmonary Adenosquamous Carcinoma

Figure 1

Axial T1-weighted MR images (a) demonstrate two isointense penile masses involving the left paracentral shaft base and proximal right corpus cavernosum (solid arrows) demonstrated with enhancement (solid arrow) on axial contrast enhanced T1-weighted MR images (b). The larger lesion at the base of the shaft demonstrates peripheral enhancement and central nonenhancement (dashed arrow), while the smaller posterior lesion homogeneously enhances. Both lesions demonstrate intrinsic heterogeneous hyperintensity (solid arrow) on axial T2-weighted MR imaging (c). Corresponding to the areas of enhancement on postcontrast MR images, PET/CT imaging (d) demonstrates hypermetabolic activity (solid arrow). A central area of decreased metabolic activity within the larger lesion (dashed arrow) corresponds to the area of central nonenhancement on MRI in keeping with central necrosis. Coronal contrast-enhanced T1-weighted MR image (e) demonstrates the larger lesion (solid arrow) extending across the intercorporal septum (dashed arrow).

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