Metachronous bilateral testicular metastases from renal cell carcinoma: a case report

Renal Cell Carcinoma with Testicular Metastases: A Case Report and Review of the Literature

“…In 11,157 patients with metastatic RCC, from 1998 to 2007, the most common sites of spread were to the lung (45.2%), bone (29.5%), distant lymph node (21.8%), and liver (20.3%); metastases to the testes were not noted in this study (13). To our knowledge, there have been less than 50 reported cases of RCC metastasis to the testis (17,(19)(20)(21)(22)(23)(24)(25)(26)(27).…”

“…A review of the available literature seems to suggest that metastatic spread to the ipsilateral testis is more common than contralateral or bilateral spread (17,(19)(20)(21)(22)(23)(24)(25)(26)(27). It has been hypothesized that metastasis occurs by retrograde venous spread, especially considering the anatomic relationship between the left renal and gonadal veins (28).…”

“…It has been hypothesized that metastasis occurs by retrograde venous spread, especially considering the anatomic relationship between the left renal and gonadal veins (28). To account for contralateral and bilateral metastases, it has been suggested that metastases might spread by Batson's venous plexus (23). Other hypotheses include arterial and lymphatic involvement, as well as iatrogenic seeding (25,29).…”

“…However, metastatic carcinomas to the testes are most commonly detected incidentally during autopsy (30). Metastases to the testis have also been diagnosed, both prior to initial treatment of RCC and up to 7 years following treatment (17,(19)(20)(21)(22)(23)(24)(25)(26)(27). Metastatic burden is also variable, as patients ranged from having a solitary testicular metastasis to widespread involvement of multiple organs (17,(19)(20)(21)(22)(23)(24)(25)(26)(27).…”