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Gözen AS, Koudonas A, Senel S, Colecchia M, Rassweiler J. Preperitoneal vas deferens infiltration in high-risk prostate cancer. BJUI COMPASS 2024; 5:159-165. [PMID: 38179022 PMCID: PMC10764168 DOI: 10.1002/bco2.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/10/2023] [Accepted: 08/26/2023] [Indexed: 01/06/2024] Open
Abstract
Objectives The objective of this study is to evaluate the prevalence and the importance of preperitoneal vas deferens (VD) infiltration in high-risk prostate cancer (PCa). Patients and Methods In this prospectively designed study, we included 332 high-risk PCa patients with a Briganti score >5%, who were treated by robot-assisted radical prostatectomy between July 2017 and February 2022 at the Urology Department, SLK Kliniken Heilbronn. In addition to the standard histological analysis of the distal VD, which was attached to the prostate specimen, we analysed the infiltration status of preperitoneal VD in this cohort. The preperitoneal VD, which represents the middle part of ductus deferens and extends between the internal inguinal ring and obturator fossa, was resected during extended pelvic lymphadenectomy. Distal and preperitoneal VD status was registered together with preoperative and postoperative disease characteristics. Descriptive analysis methods and logistic regression analysis were used. Results Briganti score of the target cohort had a median value of 19%, while 235 patients (70.8%) of the group demonstrated a locally advanced disease. The Grade Group at prostatectomy specimen was at least 3 for 286 patients (86.1%). Distal VD infiltration was found in 20 patients (6%) and preperitoneal VD infiltration in two patients (0.6%). Distal VD infiltration was not associated with an increased possibility for positive surgical margins or nodal status among pT3b patients, while both patients with preperitoneal VD infiltration were characterized by highly aggressive disease in locally advanced stage and bilateral distal VD infiltration. Conclusions PCa extension along VD may reach a more proximal point of VD than the reported from the existing data infiltration of VD adjacent to seminal vesicles. This rare manifestation of PCa local extension may be the intermediate step to the rare cases of recurrence in the testicles. However, more robust data are needed to confirm the aforementioned hypothesis. Distal VD infiltration seems to have no additional prognostic value among patients with infiltrated seminal vesicles.
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Affiliation(s)
| | - Antonios Koudonas
- First Department of Urology, School of MedicineAristotle University of ThessalonikiThessalonikiGreece
| | - Samet Senel
- Department of UrologyAnkara City HospitalAnkaraTurkey
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2
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Balagobi B, Gobishangar S, Sarma S, Brammah R, Jenil A. A young patient with prostatic carcinoma with testicular metastasis. Int J Surg Case Rep 2022; 99:107653. [PMID: 36115121 PMCID: PMC9568776 DOI: 10.1016/j.ijscr.2022.107653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/07/2022] [Accepted: 09/10/2022] [Indexed: 11/28/2022] Open
Abstract
Prostate cancer is one of the most frequent cancers in males and commonly a disease of the older population, but it is increasingly seen among older adolescents and young adults. The common sites of metastasis of prostatic carcinoma are bones and regional lymph nodes. Testicular metastasis from prostatic carcinoma is an infrequent presentation. We report a case of a young patient with prostatic carcinoma and multiple metastases, including bilateral testis. A 40-year-old male presented with lower urinary tract voiding symptoms and back pain for three months. His prostate-specific antigen level was elevated at 13.98 ng/ml. A magnetic resonance imaging of the prostate revealed two PIRADS V lesions and metastases in multiple bones and regional lymph nodes. On follow up, the patient complained of bilateral testicular swelling and ultrasound scan of the testes revealed bilateral testicular metastasis. Fine needle aspiration cytology of right-side testicular lesion revealed malignant cells compatible with metastasis from prostate cancer. Later involvement of multilevel vertebral and skull metastases was identified by magnetic resonance imaging. A T3bN1M1c staging of prostate cancer was made, androgen deprivation therapy followed by chemo and radiotherapy was instituted, following extensive discussion with the patient. Unfortunately the patient succumbed to the illness during the course of treatment. This case report is of a patient with rare presentation of bilateral testicular metastasis with prostate cancer in young age.
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3
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Testicular recurrence of oligometastatic prostatic adenocarcinoma after 22 years of androgen deprivation therapy. Urol Case Rep 2022; 43:102055. [PMID: 35509726 PMCID: PMC9058943 DOI: 10.1016/j.eucr.2022.102055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/08/2022] [Accepted: 03/16/2022] [Indexed: 11/23/2022] Open
Abstract
Testicular metastasis of carcinoma is a rare condition. We report a rare case of right testicular metastasis of prostatic adenocarcinoma in an 84 years old patient, after more than 20 years of controlled disease under androgen deprivation therapy. Follow-up consisted in PSA monitoring, clinical examination, CT and bone scan. Biological recurrence, right testicular mass and finally right total orchiectomy allowed the diagnosis of a right testicular metastasis. PSA monitoring and clinical surveillance are important tools for diagnosing metastatic localisations.
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4
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Ozyigit G, Akdogan B, Yilmaz MT, Guner G, Bozkurt MF. Testicular metastasis in prostate cancer: A rare case of testicular metastasis diagnosed with 68Ga-PSMA and review of the literature. JOURNAL OF CLINICAL UROLOGY 2022. [DOI: 10.1177/20514158211068307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Objective: Testicular metastasis in prostate cancer is a rare entity. We aimed to report the case where this rare condition was diagnosed with Gallium prostate-specific membrane antigen–positron emission tomography/computed tomography (68Ga-PSMA-PET/CT). Subjects/patients and methods: A 68-year-old male with a prostate adenocarcinoma presented with testicular metastasis. The patient was diagnosed with 68Ga-PSMA-PET/CT, and bilateral inguinal orchiectomy was performed. Herein, our case is presented, and a short review of the literature is carried out. Conclusion: 68Ga-PSMA-PET/CT is an effective imaging method for detecting rare metastases. Level of evidence: 4
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Affiliation(s)
- Gokhan Ozyigit
- Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, Turkey
| | - Bulent Akdogan
- Department of Urology, Faculty of Medicine, Hacettepe University, Turkey
| | - Melek Tugce Yilmaz
- Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, Turkey
| | - Gunes Guner
- Department of Pathology, Faculty of Medicine, Hacettepe University, Turkey
| | - Murat Fani Bozkurt
- Department of Nuclear Medicine, Faculty of Medicine, Hacettepe University, Turkey
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5
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Chandran J, Palaniappan R, Purushotaman D. Bilateral testicular metastases from adenocarcinoma prostate: A rare case report with review of literature. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_228_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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6
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Kollitsch L, Hamann C, Knüpfer S, Meyer D, Kneissl P, Jüttner E, Osmonov D. [Symptomatic testicular metastasis of acinar adenocarcinoma of the prostate]. Urologe A 2020; 59:1092-1094. [PMID: 32248276 PMCID: PMC8460512 DOI: 10.1007/s00120-020-01194-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We report about the rare occurrence of symptomatic testicular metastasis of an acinar adenocarcinoma of the prostate. Testicular metastases are usually incidentally detected in patients treated with bilateral orchiectomy or more often during autopsy. In the literature, there are only a few clinical cases describing symptomatic testicular metastases. However, the possibility of such metastases should be considered in patients diagnosed with advanced prostate cancer. Testicular examination should be performed regularly, even in patients with low prostate-specific antigen levels.
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Affiliation(s)
- L Kollitsch
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein-Campus Kiel, Kiel, Deutschland.
| | - C Hamann
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein-Campus Kiel, Kiel, Deutschland
| | - S Knüpfer
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein-Campus Kiel, Kiel, Deutschland
| | - D Meyer
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein-Campus Kiel, Kiel, Deutschland
| | - P Kneissl
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein-Campus Kiel, Kiel, Deutschland
| | - E Jüttner
- Institut für Pathologie, Universitätsklinikum Schleswig-Holstein-Campus Kiel, Kiel, Deutschland
| | - D Osmonov
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein-Campus Kiel, Kiel, Deutschland
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7
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Sharma S, Chaudhary GR, Kumar S, Saikia UN. Testicular Metastasis in Prostate Adenocarcinoma: a Rare and Incidental Diagnosis on Histopathology. Indian J Surg Oncol 2018; 9:284-285. [PMID: 29887721 DOI: 10.1007/s13193-016-0566-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 10/06/2016] [Indexed: 11/27/2022] Open
Affiliation(s)
- Saniya Sharma
- 1Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Gautam Ram Chaudhary
- 2Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Santosh Kumar
- 2Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Uma Nahar Saikia
- 1Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
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8
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Gao Q, Chen J, Dai Y. Prostate cancer involving bilateral seminal vesicles along with bone and testicular metastases: a case report. J Med Case Rep 2018. [PMID: 29519246 PMCID: PMC5844096 DOI: 10.1186/s13256-017-1551-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the past 20 years, the incidence of prostate cancer has risen rapidly. It has been ranked as the third most common malignant tumor of the male genitourinary system. Testicular metastasis is uncommon in prostate cancer. Most cases are incidentally found in the treatment of prostate cancer with orchiectomy. Therefore, we believed it was necessary to report the case of our patient with this disease. CASE PRESENTATION We present a case of a 69-year-old Han Chinese man with a high total prostate-specific antigen level. A transrectal ultrasound-guided prostate biopsy was performed. A pathology report showed prostate cancer tissue with a Gleason score of 4 + 4 = 8/10. Imaging findings suggested that the prostate cancer tissue involved bilateral seminal vesicles and multiple bones. Next, radioactive seed implantation was carried out, and endocrine therapy was continued after the operation. Then enlargement of the left scrotum was found along with a total prostate-specific antigen level of 19.21 ng/ml. Computed tomography of the middle abdomen and pelvic cavity revealed 2.0 × 1.3-cm lesions of the left testis. The patient underwent a left testicular high resection and right orchiectomy. The postoperative pathology report showed metastatic prostate cancer cells in the left testis. CONCLUSIONS Testicular metastasis of prostate cancer is rare. Therefore, a testicular physical examination is necessary for patients without relapse to avoid a missed diagnosis. Testicular metastasis should be treated according to the principle of treatment for advanced prostate adenocarcinoma if testicular metastasis of prostate adenocarcinoma is detected.
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Affiliation(s)
- Qingqiang Gao
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Jianhuai Chen
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Yutian Dai
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
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9
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Cho CKJ, Sigurdson S, Davidson CM, Leveridge M, Mahmud A. Case: Testicular oligometastasis from prostate cancer - Report of rare isolated recurrence after radiotherapy and intermittent androgen-deprivation therapy. Can Urol Assoc J 2017; 12:E31-E33. [PMID: 29173266 DOI: 10.5489/cuaj.4524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Testicular oligometastasis secondary to prostate cancer is rare. We present a case where a patient with locally advanced prostate cancer was treated with high-dose external beam radiotherapy and two years of androgen-deprivation therapy, followed by intermittent androgen suppression. Three and a half years after initial diagnosis, he was found to have a painless testicular mass. Orchiectomy was performed and histopathology demonstrated metastatic prostatic adenocarcinoma. He remains in clinical remission on intermittent androgen suppression eight years following initial treatment, and over four years after presentation with testicular metastasis.
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Affiliation(s)
- Chan-Kyung J Cho
- Department of Oncology, Queen's University, Kingston General Hospital; Kingston, ON, Canada.,Cancer Centre of Southeastern Ontario at Kingston General Hospital, Kingston, ON, Canada
| | - Samantha Sigurdson
- Department of Oncology, Queen's University, Kingston General Hospital; Kingston, ON, Canada
| | - Christopher M Davidson
- Department of Pathology and Molecular Medicine, Queen's University, Kingston General Hospital, Kingston, ON, Canada
| | - Michael Leveridge
- Department of Urology, Queen's University, Kingston General Hospital; Kingston, ON, Canada
| | - Aamer Mahmud
- Department of Oncology, Queen's University, Kingston General Hospital; Kingston, ON, Canada.,Cancer Centre of Southeastern Ontario at Kingston General Hospital, Kingston, ON, Canada
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10
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Testicular Metastasis From Prostatic Adenocarcinoma Presenting as Recurrent Epididymo-orchitis. Urology 2017; 108:e7-e9. [DOI: 10.1016/j.urology.2017.07.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 06/03/2017] [Accepted: 07/20/2017] [Indexed: 11/21/2022]
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11
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Maibom SL, Jacobsen A, Hansen RB, Brasso K. Isolated testicular prostate cancer metastasis. Scand J Urol 2017; 51:426-427. [PMID: 28743224 DOI: 10.1080/21681805.2017.1347818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - André Jacobsen
- b Department of Urology , Copenhagen Prostate Cancer Center , Copenhagen , Denmark
| | - Rikke Bølling Hansen
- c Department of Urology , Gentofte/Herlev University Hospital , Gentofte , Herlev , Denmark
| | - Klaus Brasso
- a Department of Urology , Rigshospitalet , Copenhagen , Denmark
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12
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Asymptomatic Solitary Metastasis to the Testis From Prostate Carcinoma Detected by FDG PET/CT. Clin Nucl Med 2016; 41:86-7. [DOI: 10.1097/rlu.0000000000001004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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Gibas A, Sieczkowski M, Biernat W, Matuszewski M. Isolated Testicular Metastasis of Prostate Cancer after Radical Prostatectomy: Case Report and Literature Review. Urol Int 2015; 95:483-5. [DOI: 10.1159/000368720] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 09/26/2014] [Indexed: 11/19/2022]
Abstract
Clinical recurrence of prostate cancer manifested as a testicular mass is an extremely rare condition. We report a case of a 58-year-old patient with a testicular tumor who underwent orchiectomy 7 years after radical prostatectomy. The pathology analysis confirmed metastasis from prostate carcinoma. After one year, the patient had no signs of biochemical and clinical recurrence. This argues for considering metastasectomy in such patients.
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14
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Korkes F, de Castro MG, de Cassio Zequi S, Nardi L, Del Giglio A, de Lima Pompeo AC. Hyaluronan-mediated motility receptor (RHAMM) immunohistochemical expression and androgen deprivation in normal peritumoral, hyperplasic and neoplastic prostate tissue. BJU Int 2013; 113:822-9. [DOI: 10.1111/bju.12339] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | | | | | | | - Auro Del Giglio
- Division of Haematology and Oncology; ABC Medical School; São Paulo Brazil
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