Abstract
Metastasis from renal cell carcinoma (RCC) to the testis is rare. This case report presented an extremely rare case of simultaneous bilateral testicular metastases from RCC in a 65-year-old man who had experienced indolent scrotal enlargement over a period of several months. Scrotal ultrasonography showed 4.0- and 2.0-cm-sized masses in the left and right testes, respectively. Contrast-enhanced computed tomography identified multiple tumors in the kidneys, the pancreas and the left adrenal gland. Left orchiectomy and pathological examination were performed and indicated testicular metastasis from clear cell RCC. The patient underwent complete surgical resection of all residual lesions. Postoperative follow-up examination without adjuvant therapy identified no recurrence over 11 months. This study also reviewed existing literature and determined that retrograde venous spread from the primary kidney tumor to the testis may be an important pathway for testicular metastasis from RCC. In conclusion, RCC can result in testicular metastases not only unilaterally, but also bilaterally, as was observed in the present case.
Highlights
Secondary neoplasms of the testis are rare, with an incidence of 0.9% in all testicular tumors according to a previous German survey [1]
Renal cell carcinoma (RCC) metastasis is frequently observed in the lungs, lymph nodes, bones, liver and the brain, it is rarely identified in the testes [5,6]
Secondary neoplasms of the testis are rare with a reported incidence of testicular metastasis of 0.02% [8] and 0.06% [2] at autopsy and testicular metastasis accounted for 0.9% of all types of testicular tumors [1]
Summary
Secondary neoplasms of the testis are rare, with an incidence of 0.9% in all testicular tumors according to a previous German survey [1]. Pathological examination revealed that the tumor cells had small, slightly oval nuclei with optically clear cytoplasm and were arranged in nests separated by a rich network of sinusoidal vascular channels (Fig. 2). These results were compatible with a diagnosis of metastasis from clear cell RCC. The patient was diagnosed with right RCC that was metastasizing to the contralateral kidney and adrenal gland, the pancreas and the testes (staging, cT1bN0M1). The pathological findings of the resected tumors were compatible with metastases from the right RCC (clear cell carcinoma, Grade II, pT1b).
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