Simultaneous bilateral testicular metastases from renal clear cell carcinoma: A case report and review of the literature

Abstract

Metastasis from renal cell carcinoma (RCC) to the testis is rare. This case report presented an extremely rare case of simultaneous bilateral testicular metastases from RCC in a 65-year-old man who had experienced indolent scrotal enlargement over a period of several months. Scrotal ultrasonography showed 4.0- and 2.0-cm-sized masses in the left and right testes, respectively. Contrast-enhanced computed tomography identified multiple tumors in the kidneys, the pancreas and the left adrenal gland. Left orchiectomy and pathological examination were performed and indicated testicular metastasis from clear cell RCC. The patient underwent complete surgical resection of all residual lesions. Postoperative follow-up examination without adjuvant therapy identified no recurrence over 11 months. This study also reviewed existing literature and determined that retrograde venous spread from the primary kidney tumor to the testis may be an important pathway for testicular metastasis from RCC. In conclusion, RCC can result in testicular metastases not only unilaterally, but also bilaterally, as was observed in the present case.

Metastatic Renal Cell Carcinoma to the Testis: A Clinicopathologic Analysis of Five Cases

“…Bandler et al described the first case of RCC metastatic to the testis in 1946 [17]. Since then, there have been 34 reported cases of testicular spread of RCC [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16].…”

“…In this circumstance, it could be misdiagnosed as one of the many types of primary testicular tumors. Most reported examples of metastatic carcinoma in the testis have been individual case reports [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Metastatic renal cell carcinoma (RCC) involving the testis comprises a small portion of this group of cases.…”

Neoplastic metastases to the endocrine glands

“…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.…”

“…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.…”

“…Renal cell carcinoma rarely spreads to the testes. The testes are regarded as a 'tumour sanctuary', as tumour cells are not able to grow easily in that environment due to the relatively low temperature of the scrotum (Moriyama et al 2014). Additionally, the presence of the blood-testis barrier formed by Sertoli cells, to protect spermatozoa, may also prevent testicular metastasis (Moriyama et al 2014).…”