Castellanos-Hernández H, Solares-Sánchez ME, Sánchez-Turati JG, Martínez-Cervera PF, Chanona-Vilchis JG, Pérez-Montiel GD, Jiménez-Ríos MÁ

Language: Spanish
References: 9
Page: 264-268
PDF size: 247.10 Kb.

ABSTRACT

Metastatic tumors to the testis, with the exception of lymphoma and leukemia, are extremely rare. The majority of these cases present at autopsy in approximately 2.5% of men with malignant tumors, or they are incidentally detected during therapeutic orchiectomy for prostate cancer. Only a small subgroup of patients has clinical manifestations of testicular metastases.
This article presents 3 cases of metastatic tumors to the testis. The first case is a 42-year-old man diagnosed with metastatic prostate adenocarcinoma who underwent simple bilateral orchiectomy as androgen deprivation therapy. The histopathologic report stated metastatic prostate adenocarcinoma in the right testis.
The second case involved an 83-year-old man diagnosed with high-risk prostate adenocarcinoma who underwent simple bilateral orchiectomy. The histopathologic study revealed metastasis and vascular invasion of prostate carcinoma into the testicular parenchyma of the right testis.
The third case was a 69-year-old man diagnosed with a right renal tumor with left pulmonary metastasis. The patient underwent radical nephrectomy and then pulmonary metastasectomy that revealed Fuhrman 4 renal cell carcinoma (RCC) with renal vein invasion and metastatic RCC to the lung, respectively. He presented with recurrence in the contralateral lung and in the brain and was managed with Sunitinib for 4 months. The patient later presented with pain and increased volume and consistency of the right testis and evaluation protocol was carried out. Right orchiectomy was performed and metastatic RCC was reported. In general, the most common primary sites are the prostate, followed by the lung, kidney, melanomas, and the gastrointestinal tract. Bilateral involvement presents in approximately 15% of cases. The high percentage of testicular metastases from prostate cancer is partially a result of the examination of a larger number of testes in tumor patients that underwent therapeutic orchiectomy.
In the cases presented herein, once testicular metastases were demonstrated pathologically, other coexisting metastases were always present, terminating in poor survival outcome for the patients.

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