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DOI: 10.1148/rg.256055069
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Imaging of Penile Neoplasms1

Ajay K. Singh, MD, Anuradha Saokar, MD, Peter F. Hahn, MD, PhD and Mukesh G. Harisinghani, MD

1 From the Divisions of Emergency Radiology (A.K.S.) and Abdominal Imaging and Interventional Radiology (A.K.S., A.S., P.F.H., M.G.H.), Massachusetts General Hospital, White 270, 55 Fruit St, Boston, MA 02114. Presented as an education exhibit at the 2004 RSNA Annual Meeting. Received March 29, 2005; revision requested April 12 and received May 16; accepted May 17. All authors have no financial relationships to disclose.


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  		Figure 1a.  Normal penile anatomy. (a) Drawing (axial view) illustrates the normal penile anatomy. 1 = corpora cavernosa, 2 = corpus spongiosum, 3 = tunica albuginea, 4 = cavernosal arteries, 5 = deep dorsal vein, 6 = superficial dorsal vein, 7 = Buck fascia, 8 = dartos tunica. (b) Axial T2-weighted MR image shows the two corpora cavernosa (straight arrows) and the ventral corpus spongiosum (curved arrow). The tunica albuginea (arrowhead) surrounds the corpora cavernosa. (c) Drawing (sagittal view) illustrates the normal penile anatomy. 1 = corpus cavernosum, 2 = corpus spongiosum, 3 = urethra, 4 = glans penis, 5 = tunica albuginea. (d) Sagittal MR image shows the corpus spongiosum (arrow) flaring posteriorly into bulbous spongiosum (arrowheads). (e) Axial T2-weighted MR image shows the base of the penis and the attachment of the posterior portion of the corpora cavernosa, known as the crura (arrowheads), to the pubic arch. (f) Sagittal contrast material–enhanced T1-weighted MR image shows the corpus cavernosum (arrow) and the corpus spongiosum (arrowhead).

 


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  		Figure 1b.  Normal penile anatomy. (a) Drawing (axial view) illustrates the normal penile anatomy. 1 = corpora cavernosa, 2 = corpus spongiosum, 3 = tunica albuginea, 4 = cavernosal arteries, 5 = deep dorsal vein, 6 = superficial dorsal vein, 7 = Buck fascia, 8 = dartos tunica. (b) Axial T2-weighted MR image shows the two corpora cavernosa (straight arrows) and the ventral corpus spongiosum (curved arrow). The tunica albuginea (arrowhead) surrounds the corpora cavernosa. (c) Drawing (sagittal view) illustrates the normal penile anatomy. 1 = corpus cavernosum, 2 = corpus spongiosum, 3 = urethra, 4 = glans penis, 5 = tunica albuginea. (d) Sagittal MR image shows the corpus spongiosum (arrow) flaring posteriorly into bulbous spongiosum (arrowheads). (e) Axial T2-weighted MR image shows the base of the penis and the attachment of the posterior portion of the corpora cavernosa, known as the crura (arrowheads), to the pubic arch. (f) Sagittal contrast material–enhanced T1-weighted MR image shows the corpus cavernosum (arrow) and the corpus spongiosum (arrowhead).

 


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  		Figure 1c.  Normal penile anatomy. (a) Drawing (axial view) illustrates the normal penile anatomy. 1 = corpora cavernosa, 2 = corpus spongiosum, 3 = tunica albuginea, 4 = cavernosal arteries, 5 = deep dorsal vein, 6 = superficial dorsal vein, 7 = Buck fascia, 8 = dartos tunica. (b) Axial T2-weighted MR image shows the two corpora cavernosa (straight arrows) and the ventral corpus spongiosum (curved arrow). The tunica albuginea (arrowhead) surrounds the corpora cavernosa. (c) Drawing (sagittal view) illustrates the normal penile anatomy. 1 = corpus cavernosum, 2 = corpus spongiosum, 3 = urethra, 4 = glans penis, 5 = tunica albuginea. (d) Sagittal MR image shows the corpus spongiosum (arrow) flaring posteriorly into bulbous spongiosum (arrowheads). (e) Axial T2-weighted MR image shows the base of the penis and the attachment of the posterior portion of the corpora cavernosa, known as the crura (arrowheads), to the pubic arch. (f) Sagittal contrast material–enhanced T1-weighted MR image shows the corpus cavernosum (arrow) and the corpus spongiosum (arrowhead).

 


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  		Figure 1d.  Normal penile anatomy. (a) Drawing (axial view) illustrates the normal penile anatomy. 1 = corpora cavernosa, 2 = corpus spongiosum, 3 = tunica albuginea, 4 = cavernosal arteries, 5 = deep dorsal vein, 6 = superficial dorsal vein, 7 = Buck fascia, 8 = dartos tunica. (b) Axial T2-weighted MR image shows the two corpora cavernosa (straight arrows) and the ventral corpus spongiosum (curved arrow). The tunica albuginea (arrowhead) surrounds the corpora cavernosa. (c) Drawing (sagittal view) illustrates the normal penile anatomy. 1 = corpus cavernosum, 2 = corpus spongiosum, 3 = urethra, 4 = glans penis, 5 = tunica albuginea. (d) Sagittal MR image shows the corpus spongiosum (arrow) flaring posteriorly into bulbous spongiosum (arrowheads). (e) Axial T2-weighted MR image shows the base of the penis and the attachment of the posterior portion of the corpora cavernosa, known as the crura (arrowheads), to the pubic arch. (f) Sagittal contrast material–enhanced T1-weighted MR image shows the corpus cavernosum (arrow) and the corpus spongiosum (arrowhead).

 


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  		Figure 1e.  Normal penile anatomy. (a) Drawing (axial view) illustrates the normal penile anatomy. 1 = corpora cavernosa, 2 = corpus spongiosum, 3 = tunica albuginea, 4 = cavernosal arteries, 5 = deep dorsal vein, 6 = superficial dorsal vein, 7 = Buck fascia, 8 = dartos tunica. (b) Axial T2-weighted MR image shows the two corpora cavernosa (straight arrows) and the ventral corpus spongiosum (curved arrow). The tunica albuginea (arrowhead) surrounds the corpora cavernosa. (c) Drawing (sagittal view) illustrates the normal penile anatomy. 1 = corpus cavernosum, 2 = corpus spongiosum, 3 = urethra, 4 = glans penis, 5 = tunica albuginea. (d) Sagittal MR image shows the corpus spongiosum (arrow) flaring posteriorly into bulbous spongiosum (arrowheads). (e) Axial T2-weighted MR image shows the base of the penis and the attachment of the posterior portion of the corpora cavernosa, known as the crura (arrowheads), to the pubic arch. (f) Sagittal contrast material–enhanced T1-weighted MR image shows the corpus cavernosum (arrow) and the corpus spongiosum (arrowhead).

 


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  		Figure 1f.  Normal penile anatomy. (a) Drawing (axial view) illustrates the normal penile anatomy. 1 = corpora cavernosa, 2 = corpus spongiosum, 3 = tunica albuginea, 4 = cavernosal arteries, 5 = deep dorsal vein, 6 = superficial dorsal vein, 7 = Buck fascia, 8 = dartos tunica. (b) Axial T2-weighted MR image shows the two corpora cavernosa (straight arrows) and the ventral corpus spongiosum (curved arrow). The tunica albuginea (arrowhead) surrounds the corpora cavernosa. (c) Drawing (sagittal view) illustrates the normal penile anatomy. 1 = corpus cavernosum, 2 = corpus spongiosum, 3 = urethra, 4 = glans penis, 5 = tunica albuginea. (d) Sagittal MR image shows the corpus spongiosum (arrow) flaring posteriorly into bulbous spongiosum (arrowheads). (e) Axial T2-weighted MR image shows the base of the penis and the attachment of the posterior portion of the corpora cavernosa, known as the crura (arrowheads), to the pubic arch. (f) Sagittal contrast material–enhanced T1-weighted MR image shows the corpus cavernosum (arrow) and the corpus spongiosum (arrowhead).

 


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  		Figure 2.  Drawing illustrates local staging of penile neoplasms: T1, invasion of subepithelial connective tissue; T2, invasion of one or more corpora; T3, invasion of urethra or prostate gland; T4, invasion of other adjacent structures; and Tis, carcinoma in situ.

 


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  		Figure 3.  Verrucous carcinoma of the penis. Sagittal T2-weighted MR image demonstrates a mass with heterogeneous signal intensity (arrowheads) involving the glans penis and the corpora cavernosa.

 


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  		Figure 4.  Squamous cell carcinoma of the penis. Coronal T2-weighted MR image shows a mass with heterogeneous signal intensity (arrowhead) involving the corpora cavernosa. Hydrocele is seen incidentally.

 


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  		Figure 5a.  Adenoid cystic carcinoma arising from the Cowper gland. Coronal T2-weighted (a) and gadolinium-enhanced T1-weighted (b) MR images show a mass (arrow) centered at the bulbous urethra and infiltrating the left obturator internus muscle.

 


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  		Figure 5b.  Adenoid cystic carcinoma arising from the Cowper gland. Coronal T2-weighted (a) and gadolinium-enhanced T1-weighted (b) MR images show a mass (arrow) centered at the bulbous urethra and infiltrating the left obturator internus muscle.

 


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  		Figure 6.  Penile metastases from a prostatic primary neoplasm. Sagittal contrast-enhanced T1-weighted MR image shows extensive multiple low-signal-intensity lesions (circled) involving the corpora cavernosa and the corpus spongiosum.

 


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  		Figure 7a.  Metastatic left groin lymphadenopathy from penile carcinoma. (a) T2*-weighted MR image obtained before the administration of ultrasmall superparamagnetic iron oxide particles shows an enlarged lymph node in the left groin (arrow). (b) On a T2*-weighted MR image obtained after administration of the iron oxide particles, the enlarged lymph node (arrow) appears bright due to lack of particle uptake, a finding that indicates replacement of the lymph node parenchyma by metastatic tissue. A smaller left inguinal lymph node (arrowhead) shows normal particle uptake and is hypointense owing to susceptibility effect.

 


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  		Figure 7b.  Metastatic left groin lymphadenopathy from penile carcinoma. (a) T2*-weighted MR image obtained before the administration of ultrasmall superparamagnetic iron oxide particles shows an enlarged lymph node in the left groin (arrow). (b) On a T2*-weighted MR image obtained after administration of the iron oxide particles, the enlarged lymph node (arrow) appears bright due to lack of particle uptake, a finding that indicates replacement of the lymph node parenchyma by metastatic tissue. A smaller left inguinal lymph node (arrowhead) shows normal particle uptake and is hypointense owing to susceptibility effect.

 


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  		Figure 8.  Squamous cell carcinoma of the penis. Axial contrast-enhanced CT scan shows a focal enhancing mass in the right corpus cavernosum (arrows).

 


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  		Figure 9.  Lymph node metastases from penile carcinoma. Contrast-enhanced CT scan shows bilateral metastatic lymph node involvement (arrowheads) in the form of inguinal and right common iliac lymphadenopathy.

 




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