Bilateral Testicular Metastases from Occult Primary Prostate Cancer in a Young Adult: A Rare Case Report

Kamble, Vijaya Rajesh; Agrawal, Pallavi

doi:10.7860/jcdr/2017/25292.9783

Cited by 5 publications

(9 citation statements)

References 6 publications

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“…Krukenberg tumours, defined as ovarian metastases from gastrointestinal tumours, account for only 1-2% of all ovarian tumours (Kammar et al 2017). Excluding leukaemia and lymphoma, metastases to the testis are rare, ranging from 0.02% to 2.5% in autopsy series (Moriyama et al 2014, Kamble & Agrawal 2017. Metastases represent 1.4% of all testicular tumours biopsied (Dutt et al 2000) with the most common primaries being prostate (35%), lung (19%), malignant melanoma (9%), colon (9%), and kidney tumours (7%) (Dogra et al 2003, Zhou et al 2019.…”

Section: Gonads (Ovaries and Testes) Epidemiologymentioning

confidence: 99%

“…A total of 57 cases of testicular or paratesticular neuroblastoma have been reported in children, and most cases represented metastases (Kebudi et al 2019). Testicular metastases are detected incidentally after orchidectomy or at autopsy in up to 4% cases of prostate cancer (Moriyama et al 2014, Kamble & Agrawal 2017.…”

Section: Gonads (Ovaries and Testes) Epidemiologymentioning

confidence: 99%

“…The renal-ovarian axis appears to play a significant role through the direct drainage of the left ovarian venous outflow into the left renal vein (Anagnostou et al 2009). The most plausible hypothesis for the spread of prostatic cancer to the testis is the retrograde venous extension or embolism, arterial embolism, lymphatic extension and endo-canalicular spread (Kamble & Agrawal 2017). Renal cell carcinoma rarely spreads to the testes.…”

Section: Pathogenesismentioning

confidence: 99%

“…Contrast-enhanced US (CEUS) and ultrasonic elastography may contribute to differentiation from benign intra-testicular lesions to avoid unnecessary orchidectomy (Auer et al 2017). The main characteristics of the testes with metastases include a bulky, heterogeneous multiple hypoechoic lesions within the testis, and raised vascularity on colour Doppler (Kamble & Agrawal 2017, Kawamoto et al 2018. In CT imaging the testes can be bulky and heterogeneous with significant heterogeneous enhancement on post-contrast analysis.…”

Section: Imagingmentioning

confidence: 99%

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Neoplastic metastases to the endocrine glands

Angelousi

Alexandraki

Kyriakopoulos

et al. 2020

Endocrine-Related Cancer

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Endocrine organs are metastatic targets for several primary cancers, either through direct extension from nearby tumour cells or dissemination via the venous, arterial and lymphatic routes. Although any endocrine tissue can be affected, most clinically relevant metastases involve the pituitary and adrenal glands with the commonest manifestations being diabetes insipidus and adrenal insufficiency respectively. The most common primary tumours metastasing to the adrenals include melanomas, breast and lung carcinomas, which may lead to adrenal insufficiency in the presence of bilateral adrenal involvement. Breast and lung cancers are the most common primaries metastasing to the pituitary, leading to pituitary dysfunction in approximately 30% of cases. The thyroid gland can be affected by renal, colorectal, lung and breast carcinomas, and melanomas, but has rarely been associated with thyroid dysfunction. Pancreatic metastasis can lead to exo-/endocrine insufficiency with renal carcinoma being the most common primary. Most parathyroid metastases originate from breast and lung carcinomas and melanoma. Breast and colorectal cancers are the most frequent ovarian metastases; prostate cancer commonly affects the testes. In the presence of endocrine deficiencies, glucocorticoid replacement for adrenal and pituitary involvement can be life saving. As most metastases to endocrine organs develop in the context of disseminated disease, surgical resection or other local therapies should only be considered to ameliorate symptoms and reduce tumour volume. Although few consensus statements can be made regarding the management of metastases to endocrine tissues because of the heterogeneity of the variable therapies, it is important that clinicians are aware of their presence in diagnosis.

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Section: Gonads (Ovaries and Testes) Epidemiologymentioning

confidence: 99%

Section: Gonads (Ovaries and Testes) Epidemiologymentioning

confidence: 99%

Section: Pathogenesismentioning

confidence: 99%

Section: Imagingmentioning

confidence: 99%

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Neoplastic metastases to the endocrine glands

Angelousi

Alexandraki

Kyriakopoulos

et al. 2020

Endocrine-Related Cancer

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“…Testicular and epididymal metastases are very rare and are reported to have an incidence of between 0.18% and 0.5% [ 5 , 6 ]. They are usually unilateral, although bilateral cases have been reported [ 7 ]. Findings of testicular metastases are mostly incidental on postmortem examination or orchidectomy either as part of the hormonal therapy or for other indications [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Bilateral secondary testicular, epididymal and spermatic cords carcinoma of prostatic origin: a case report and review of the literature

Olorunsola

Etonyeaku

Lekwa³

et al. 2021

J Med Case Reports

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Background Prostatic carcinoma is emerging as the most common male malignancy in Nigeria and the second most common male cancer worldwide. Patients often present with locally advances stages, and common sites of metastasis are the spine, pelvis, chest, and long bones. Metastases to the testes and spermatic cords are reputed to be rare and may be indicative of a worse outcome, when they occur. We recently encountered a clinical case of bilateral testicular, epididymal and spermatic cords prostatic cancer metastases. Case presentation A 71-year-old Nigerian man, who presented at our hospital with 1-month-old complaints of inability to walk together with low back and bilateral thigh pains. This presentation had been preceded by a 5-month history of lower urinary tract symptoms. On examination, the prostate was hard and nodular as were the left testis and spermatic cord. On histological assessment of a needle biopsy, prostatic adenocarcinoma (Gleason score 5 + 5 = 10) was diagnosed. A subsequent therapeutic bilateral total orchidectomy specimen was found to contain metastatic prostatic carcinoma deposits, in the testes, epididymides, and spermatic cords. Although our patient is currently doing well postoperatively on zoledronic acid, ketoconazole, bicalutamide, and tamsulosin, he is being re-evaluated periodically for any feature of recurrence. Conclusion Since it has implications for eventual outcome, every clinically suspicious therapeutic orchidectomy specimen should be subjected to a detailed histopathological examination in order to exclude secondaries from the primary prostatic malignancy.

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An occult urothelial carcinoma with wide multiorgan metastases and its genetic alteration profiling

Shi

Yang

et al. 2019

Medicine

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Rationale: Urothelial carcinoma, also named transitional cell carcinoma, is the most frequent occurring malignancy in the urinary system. It mainly invades the surrounding tissues and metastasizes to distant organs in later stages. Patient concerns: Here, we presented an unusual case of occult urothelial carcinoma primarily manifested as a multiorgan metastatic cancer in a 59-year-old man. The patient complained of pain on the left thigh root for a month. The imaging and histopathological examination revealed multiple malignancies in lung, bone, and liver. Diagnoses: The histological evaluation and the immunohistochemistry (IHC) profile of liver, lung, and bone were consistent with the diagnosis of metastases from the original urothelial cancer, while imaging examination was not able to detect a primary lesion in the urinary system. Interventions: Based on the mutation of STK11 M51Ifs∗106 detected by next generation sequencing (NGS), we started targeted therapy with everolimus. Outcomes: The patient deteriorated after 3 months of treatment and passed away. Lessons: In this initial report of occult urothelial carcinoma, we obtained information on genetic variations of tumor tissue which could provide important information for subsequent studies on this kind of disease.

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Bilateral Testicular Metastases from Occult Primary Prostate Cancer in a Young Adult: A Rare Case Report

Cited by 5 publications

References 6 publications

Neoplastic metastases to the endocrine glands

Neoplastic metastases to the endocrine glands

Bilateral secondary testicular, epididymal and spermatic cords carcinoma of prostatic origin: a case report and review of the literature

An occult urothelial carcinoma with wide multiorgan metastases and its genetic alteration profiling

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