Incidentally Detected Testicular Metastasis in a Case of Prostatic Adenocarcinoma

Abstract

Adenocarcinoma of the prostate is one of the common cancers among elderly men worldwide. However, testicular metastasis detected incidentally after orchiectomy is a rare presentation as most commonly we encounter patients presenting with bone metastasis at the time of primary diagnosis. Here, we describe a recently diagnosed case of prostatic carcinoma that had metastasis in a single testis, incidentally detected in the orchiectomy histopathological specimen, performed for surgical castration and emphasize the importance of routine microscopical examination of the testicular specimens.

Case report of metastatic prostate cancer to testicles: An ominous sign of advanced disease

“…Most of the patients who develop secondary metastases to the testis are in their sixth or seventh decades of life. This is in stark contrast to primary testicular germ cell neoplasms, which typically present in younger men 1 . Therefore, masses seen on ultrasound at older ages in patients with primary cancers should raise concern for possible metastases.…”

“…Prostate cancer typically presents with metastases to the bone, distant lymph nodes, liver, and thorax 1 . Patients with metastases to the testis typically present with a lump in the testis in the presence of an underlying known primary malignancy 2 .…”

“…Patients with undiagnosed prostate cancer may present with symptoms such as increased urinary frequency and straining with urination. Metastases may be present, typically in the axial skeletal region 1 . To date, few patients have presented with metastases to the testicles.…”

Painful testicular metastasis from prostate adenocarcinoma

“…A smaller number do document cases of patients who had testicular metastases at presentation 11 12. Some cases describe incidentally discovered testicular metastases, diagnosed incidentally following radical orchidectomy for the purposes of surgical castration 13. In most instances, testicular secondaries are unilateral, with rare bilateral involvement 14–16.…”

Metastatic testicular and epididymal lesions in a patient with advanced prostate cancer: a case report and literature review

“…Ранее в отечественной литературе подобных сообщений представлено не было. Метастатическое поражение яичек встречается редко, чаще -у мужчин старше 60-70 лет с распространенными формами РПЖ и, как правило, является случайной находкой после двусторонней орхэктомии, выполненной в целях хирургической кастрации [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. Ряд авторов описали симптоматические формы заболевания в виде увеличения, уплотнения мошонки и появления болезненности яичек [23][24][25][26][27][28][29][30][31][32][33].…”