A Rare Cause of Testicular Metastasis: Upper Tract Urothelial Carcinoma

Abstract

Metastatic testicular cancers are rare. Primary tumor sources are prostate, lung, and gastrointestinal tract for metastatic testicular cancers. Metastasis of urothelial carcinoma (UC) to the testis is extremely rare. Two-thirds of upper tract urothelial carcinoma (UTUC) is of invasive stage at diagnosis and metastatic sites are the pelvic lymph nodes, liver, lung, and bone. We report a rare case of metastatic UTUC to the testis which has not been reported before, except one case in the literature. Testicular metastasis of UC should be considered in patients with hematuria and testicular swelling.

Ureteral carcinoma metastasizing to the testicle: Can misdiagnosis of orchiepididymitis be avoided?

“…Misleading testicular metastasis from urothelial carcinomas of the upper urinary tract, mimicking orchiepididymitis, have been already reported in literature, both for upper and lower ureteral locations [ Table 1 ]. [ 5 6 7 8 ]…”

<p>Testicular Metastasis from Urothelial Carcinoma of the Renal Pelvis: A Rare Case and Review of the Literature</p>

“…8 The most common mechanism of tumor spread in urothelial carcinoma (UC) is the lymphovascular system. 1 However, the molecular mechanisms of the blood-testis and blood-epididymis barriers for preventing metastatic spread to the testis and how metastases overcome these protective mechanisms remain unclear. 7 A few case reports describing UC metastasis to the testis are available in the literature.…”

“…All of the cases in those reports of metastatic UC to the testis had tumor origins in the bladder or prostatic urethra. 1,4,12 Only two case reports are available in the present literature regarding UTUC metastasizing to the testis. 1,13 The presented case indicates an unusual biological behavior of UTUC for the third time.…”

“…1,4,12 Only two case reports are available in the present literature regarding UTUC metastasizing to the testis. 1,13 The presented case indicates an unusual biological behavior of UTUC for the third time. Although radical nephroureterectomy (with bladder cuff) is the most effective choice for the treatment of renal pelvis carcinoma, there are still few good therapeutic effects for patients with multiple metastases, and the prognosis of these patients is usually poor.…”

“…There is a high multiple-organ metastatic recurrence rate at different sites, such as the lung, liver, bone and pelvic lymph nodes. 1,2 Metastasis of UTUC to the testicles is extremely rare. Herein, we report a case of a renal pelvis carcinoma with serial testicular, lung, liver and retro-peritoneal lymph node metastasis diagnosed during follow-up following radical nephroureterectomy (with bladder cuff).…”