Penile Carcinoma Presented with Ilioinguinal Lymphadenopathy, Below-knee Skeletal Metastases, and Peritoneal Superscan on 18F FDG PET/CT.

Penile squamous cell carcinoma (PSCC) is an uncommon malignancy in males, often associated with a poor prognosis following metastatic dissemination. We report the case of a 46-year-old male who presented with a rare and extensive metastatic profile of PSCC, as detected by ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography following penectomy. The scan demonstrated extensive hypermetabolic metastatic involvement, including bilateral inguinal and external iliac lymph nodes, multiple lytic osseous metastases, and diffuse peritoneal carcinomatosis, the latter presenting in the form of peritoneal superscan. In addition, skeletal metastases extended below the knees, affecting both tibiae - an atypical metastatic site for PSCC. Despite the aggressive molecular imaging findings, the patient opted against further therapeutic interventions and succumbed to the disease 45 days later at home, highlighting the fulminant and disseminated nature of this malignancy.