Rare Case of Testicular Metastasis of Prostate Carcinoma after 13 Years of Prostatectomy: A Case Report and Review of the Literature

Abstract

Metastasis of prostate cancer to the testes is a rare phenomenon, often indicating advanced-stage disease. This case report details a 79-year-old man with a history of prostate cancer, who underwent endoscopic-extraperitoneal radical prostatectomy and bilateral pelvic lymph node dissection. The patient subsequently received radiation therapy for local recurrences. Thirteen years post-surgery, a testicular ultrasound revealed a cystic mass in the left testis, initially suspected to be a primary neoplasm. However, pathology with immunohistochemical analyses confirmed metastasis from prostate adenocarcinoma. Testicular metastasis of prostate cancer is uncommon, underscoring the aggressiveness and potential spread of the tumor. Clinically evident testicular metastases develop in only a small percentage of prostate cancer patients. This case report highlights the importance of considering metastatic disease in the differential diagnosis of testicular masses and the necessity of clinicopathologic correlation in such evaluations. Early detection and accurate diagnosis are crucial for managing testicular metastasis and improving patient outcomes. The case also emphasizes the significance of long-term follow-up in prostate cancer patients, as metastasis can occur many years post-initial treatment. Furthermore, it illustrates the critical role of advanced imaging techniques and thorough pathological assessments in identifying and managing metastatic spread. This report contributes to the limited but growing body of literature on testicular metastasis from prostate cancer, providing insights for clinicians in recognizing and managing this rare but serious complication. It underscores the need for ongoing research to better understand the mechanisms of metastatic spread and develop targeted therapeutic strategies.