Testicular metastasis from renal cell carcinoma after nephrectomy and on tyrosine kinase inhibitors therapy: Case report and review

Abstract

Renal cell carcinoma has extremely heterogeneous presentation at the diagnosis: it may present as a confined organ disease, locally advanced, metastatic to locoregional lymph nodes or with single or multiple systemic metastases. Since chemotherapy and radiation therapy have not demonstrated efficacy either in primary therapy or in neo-adjuvant or adjuvant therapy for renal clear cell carcinoma, targeted agents like tirosine kinase inhibitors were developed and are largely used in locally advanced and metastatic renal cell carcinoma. Here, we present a rare case of ipsilateral renal cell carcinoma testicle metastasis, after radical nephrectomy and during tyrosine kinase inhibitors therapy. In addition, a retrospective search in PubMed, ScienceDirect, and Web of Science database on testicular metasteses from renal cell carcinoma under tyrosine kinase inhibitors therapy was performed.

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).…”

Are tyrosine kinase inhibitors an effective treatment in testicular metastases from kidney cancer? Case report

“…Although RCC commonly results in metastases to various organs, it rarely spreads to the testes. 1 The testis is an uncommon site for metastases and the most common cancer types that metastasize to the testes are prostate (35%), lung (19%), melanoma (9%), colon tumors (9%), and RCC (7%). 2 Testicular metastases are rare because the testes are "tumor sanctuary."…”

“…In 2019, De Gobbi et al reported the case of a patient who had started sunitinib for metastatic RCC 1 month before the onset of testicular metastasis. 1 Sunitinib appeared to be ineffective against testicular localization of RCC. The authors speculated that this finding was related to the lack of expression of CD-117 (c-Kit) in testicular metastasis, which is one of the molecular targets of sunitinib treatment.…”

“…The most common sites of metastatic disease in RCC are lung, regional lymph nodes, bone, liver, and brain. 1 According to the literature, testicular metastases from RCC are extremely rare. In metastatic RCC, tyrosine kinase inhibitors (TKIs) showed impressive antitumor efficacy, but no data about efficacy on testicular metastases from RCC are available.…”

“…In metastatic RCC, tyrosine kinase inhibitors (TKIs) showed impressive antitumor efficacy, but no data about efficacy on testicular metastases from RCC are available. 1 We present a case of RCC testicular metastasis that arose during TKI treatment. We reviewed previously reported cases of testicular metastasis from RCC, performing a retrospective search in PubMed using the keywords "tyrosine kinase inhibitor," "TKI," "renal cell carcinoma," "RCC," "kidney cancer," "testicular metastasis," "testicular metastases," "scrotal metastasis," and "scrotal metastases" in February 2021.…”