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Case Reports
. 2018 Apr;5(2):127-130.
doi: 10.1016/j.ajur.2017.03.001. Epub 2017 Mar 8.

A rare case of isolated castrate resistant bilateral testicular metastases in advanced prostate cancer

Jiarui Su  1 , Edwin Jonathan Aslim  1 , Hakan Aydin  2 , Puay Hoon Tan  3 , Henry Sun Sien Ho  1
Affiliations
Case Reports

A rare case of isolated castrate resistant bilateral testicular metastases in advanced prostate cancer

Jiarui Su et al. Asian J Urol. 2018 Apr.

Abstract

Testicular metastasis is rare with the prostate being the most common site of primary cancer. We report a case of a 72-year-old man with castration-resistant prostate cancer (CRPC) and known metastases to bone and lymph nodes, who developed bilateral painful swollen testes 3 years after the initial diagnosis of prostate cancer. He had first presented with lower urinary tract symptoms (LUTS) with suspicious findings on digital rectal examination of the prostate, and an elevated serum prostate specific antigen (PSA) level of 129 ng/mL. Transrectal prostate biopsy revealed Gleason 4 + 5 adenocarcinoma. Radiological staging showed locally advanced prostate cancer with extensive metastases to bone and pelvic and retroperitoneal lymph nodes. He was given hormonal therapy for over 2 years until progression to CRPC. Six months later he developed painful bilateral testicular swellings, and serum markers for testicular germ cell cancer were normal. Bilateral orchiectomy was performed, showing metastatic prostate cancer (Gleason 4 + 5) on histology. One month postoperatively his PSA level dropped to 0.1 ng/mL from a presurgery level of 6.24 ng/mL.

Keywords: Castration-resistant prostate cancer; Metastases; Orchiectomy; Testicular tumor.

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Figures

Figure 1
Figure 1
Prostate specific antigen (PSA) trend. Depicted along the timeline are commencement of androgen deprivation monotherapy (open arrowhead), complete androgen blockade (closed arrowhead), and orchiectomy (arrow).
Figure 2
Figure 2
Histopathology of testes. (A) hematoxylin and eosin staining. (B) hematoxylin and eosin staining. Tumor shows infiltrating pattern in-between seminiferous tubules, and is comprised of fused glands, cribriform spaces and solid sheet-like areas which are consistent with high grade prostatic carcinoma (Gleason score 4 + 5 = 9).
Figure 3
Figure 3
Prostate specific antigen immunostaining is positive while seminiferous tubule is negative.
See this image and copyright information in PMC

References

    1. Bubendorf L., Schopfer A., Wagner U., Sauter G., Moch H., Willi N. Metastatic patterns of prostate cancer: an autopsy study of 1589 patients. Hum Pathol. 2000;31:578–583. - PubMed
    1. Ulbright T.M., Young R.H. Metastatic carcinoma to the testis: a clinicopathologic analysis of 26 nonincidental cases with emphasis on deceptive features. Am J Surg Pathol. 2008;32:1683–1693. - PubMed
    1. Lu L.Y., Kuo J.Y., Lin T.L., Chang Y.H., Chen K.K., Pan C.C. Metastatic tumors involving the testes. J Urol ROC. 2000;11:12–16.
    1. Tu S.M., Reyes A., Maa A., Bhowmick D., Pisters L.L., Pettaway C.A. Prostate carcinoma with testicular or penile metastases. Clinical, pathologic, and immunohistochemical features. Cancer. 2002;94:2610–2617. - PubMed
    1. Schwerk W.B., Schwerk W.N., Rodeck G. Testicular tumors: prospective analysis of real-time US patterns and abdominal staging. Radiology. 1987;164:369–374. - PubMed

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