Sarcoma of the Penis Following Pelvic Radiotherapy for Prostate Cancer: A Case Report

We present a case report of an 82-year-old patient with a history of prostate cancer treated by prostatectomy, radiotherapy, and hormonal therapy. He developed afterwards an indurated penile mass with urinary obstruction. Biopsy confirmed the diagnosis of leiomyosarcoma. Radiotherapy is a well-known risk factor for sarcomas. Post-radiation sarcoma is defined as the appearance of a sarcoma within the field of previous therapeutic irradiation, histologically different from the treated tumor. The latency period is not well defined, but a long latency period is considered as a risk factor for sarcoma, as well as advanced age, and lymphedema. The relationship between radiation dose and sarcoma risk remains debated. Leiomyosarcoma of the penis is very rare and can present with symptoms of dysuria or urinary obstruction. Post radiation sarcomas are hard to treat, and surgical treatment remains a mainstay of treatment. The prognosis varies depending on tumor location and size but is often poorer compared to sporadic primary sarcomas. Secondary malignancies after radiotherapy are a growing problem because of the increased number of long-term cancer survivors, and it should be included in management discussion. Further studies on the risk and latency period are required to develop better strategies for patient care.