A case of prostatic metastasis from non-seminomatous testicular cancer

Abstract

Introduction: Prostatic metastasis from testicular cancer is extremely rare, with only 10 reported cases, all of which were diagnosed as relapse. Herein, we report the case of a patient with concurrent testicular cancer and prostatic metastasis.

Case presentation: A 57-year-old man presented at our emergency department with urinary retention. A painless mass was found in the right scrotum, and computed tomography showed lung, mediastinal, and liver metastases, and an enlarged prostate. Tumor markers were measured in 2057 U/L lactate dehydrogenase, 2460 mIU/mL human chorionic gonadotrophin, 1303 ng/mL alpha-fetoprotein, and 1.51 ng/mL prostate specific antigen. An orchiectomy and biopsy were performed; the pathological results showed immature teratomas, embryonal carcinomas, choriocarcinomas, and seminomas in the testis, and embryonal carcinomas in the prostate, liver, and mediastinum. The patient refused chemotherapy and died 3 months following diagnosis.

Conclusion: Prostatic metastasis should be considered in cases of dysuria or prostate enlargement in testicular cancers.

Keywords: metastatic testicular cancer; non‐seminomatous testicular cancer; prostatic metastasis; testicular cancer; urinary retention.

Fig. 1

Contrast‐enhanced computed tomography revealed a 10‐cm primary mass in the right testis (a) and multiple metastasis in the mediastinum (b), liver (c), and enlarged prostate (d).

Fig. 2

Pelvic magnetic resonance imaging revealed a 7‐cm enlarged prostate, protruding into the bladder: (a) T2WI, (b) DWI, as well as a right testicular tumor: (c) T2WI and (d) DWI.

Fig. 3

The pathological results of the right high inguinal orchiectomy. (a) The pathology identified areas of immature teratoma (yellow arrow), embryonal carcinoma (black arrow), choriocarcinoma, and seminoma in the testis (hematoxylin and eosin staining, magnification 10×). (b)Enlargement of the components of embryonal cancer (hematoxylin and eosin staining, magnification 20×). (c) Immunostaining of CD30 was positive in the components of embryonal cancer. (d) The pathological results of the prostate biopsy. Immunohistochemistry was positive for CD30, indicating prostatic metastasis from testicular cancer, whose component is embryonal carcinoma.

Fig. 4

Changes in the tumor markers and image findings from the first visit.