1
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Woortman C, van Leenders GJLH, Hugen N, van Oijen MGH, Nagtegaal ID. Origin and outcome of metastatic tumours to the testes: a nationwide study. BJU Int 2024; 133:305-313. [PMID: 37877215 DOI: 10.1111/bju.16212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
OBJECTIVES To perform a retrospective cohort analysis for metastatic tumours in the testes to explore the timing, presentation and prognosis of this particular type of metastases and the factors that influence outcome. PATIENTS AND METHODS A nationwide retrospective review of pathology reports of patients with pathologically confirmed metastases to the testis between 1991 and 2021 was performed. Data were collected from the Dutch nationwide pathology databank (PALGA) and the Netherlands Cancer Registry. Log-rank testing and Kaplan-Meier analyses were used to assess overall survival (OS), and Cox proportional hazard models were used for multivariate survival analysis. RESULTS A total of 175 patients with a testicular metastasis were included. The median (range) age at diagnosis of testicular metastasis was 67 (3-88) years. Testicular metastases originated from a variety of primary tumours, although most frequently from the prostate (40.6%), kidney (13.7%), colon (10.3%), bladder (7.4%) and skin (5.7%). Synchronous testicular metastasis was detected in 53 cases, while 114 metachronous lesions were found after a median (interquartile range) interval of 22 (1-53) months after the original cancer diagnosis. OS after the diagnosis of a testicular metastasis was poor, with a median survival of 14.2 months (95% confidence interval 10.2-18.3). Primary tumour origin was an independent factor for survival, with worst survival for patients with primary skin, bladder and colon cancer. CONCLUSION Testicular metastases are very uncommon and arise mainly from primary tumours anatomically close to the testes. Most patients develop metachronous testicular metastasis at an oligometastatic disease stage. These metastases are invariably associated with poor survival.
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Affiliation(s)
- Carmen Woortman
- Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Geert J L H van Leenders
- Department of Pathology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
| | - Niek Hugen
- Department of Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Martijn G H van Oijen
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Iris D Nagtegaal
- Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- PALGA Foundation, Houten, The Netherlands
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2
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Allaume P, Khene ZE, Peyronnet B, Mathieu R, Bensalah K, Rioux-Leclercq N, Kammerer-Jacquet SF. [Secondary tumors localized in testis]. Ann Pathol 2023; 43:361-372. [PMID: 36822906 DOI: 10.1016/j.annpat.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 09/27/2022] [Accepted: 01/12/2023] [Indexed: 02/23/2023]
Abstract
Testis tumors are uncommon in oncology, and testicular metastasis from distant solid tumors are even rarer. We present two cases encountered in our department of pathology in CHU de Rennes, France. Moreover, we collected all reported cases in the Medline/PubMed databases of non-hematopoietic secondary testis tumors in adults, excluding autopsy studies, to propose an integrative study on this topic. In total, we report 98 cases of secondary testis lesions to prostate (n=38, 38.77 %), colorectal (n=19, 19.39%), gastric (n=12, 12.24%), kidney (n=7, 7.14%), lung (n=6, 6.12%) and other primary cancers. The median age at diagnosis was 66.5 years. We identified significantly more prostate adenocarcinoma (P<0.0001) when the primary tumor was known and significantly more colorectal adenocarcinoma (P=0.035) and pancreatic adenocarcinoma (P=0.002) when the primary tumor was unknown. The age at diagnosis was older when the primary tumor was known (P=0.007). We present the challenges for the diagnosis and propose some elements for diagnosis orientation. Finally, we discuss the possible ways of metastatic dissemination from primary site to testis, as illustrated by the two cases we present.
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Affiliation(s)
- Pierre Allaume
- Service anatomie pathologique, CHU de Rennes-université de Rennes 1 Hôpital Pontchaillou, 2, rue Henri Le Guilloux, 35033 Rennes Cedex 9, France.
| | - Zine-Eddine Khene
- Service d'urologie, CHU de Rennes-université de Rennes 1 Hôpital Pontchaillou, 2, rue Henri Le Guilloux, 35033 Rennes Cedex 9, France
| | - Benoît Peyronnet
- Service d'urologie, CHU de Rennes-université de Rennes 1 Hôpital Pontchaillou, 2, rue Henri Le Guilloux, 35033 Rennes Cedex 9, France
| | - Romain Mathieu
- Service d'urologie, CHU de Rennes-université de Rennes 1 Hôpital Pontchaillou, 2, rue Henri Le Guilloux, 35033 Rennes Cedex 9, France
| | - Karim Bensalah
- Service d'urologie, CHU de Rennes-université de Rennes 1 Hôpital Pontchaillou, 2, rue Henri Le Guilloux, 35033 Rennes Cedex 9, France
| | - Nathalie Rioux-Leclercq
- Service anatomie pathologique, CHU de Rennes-université de Rennes 1 Hôpital Pontchaillou, 2, rue Henri Le Guilloux, 35033 Rennes Cedex 9, France
| | - Solène-Florence Kammerer-Jacquet
- Service anatomie pathologique, CHU de Rennes-université de Rennes 1 Hôpital Pontchaillou, 2, rue Henri Le Guilloux, 35033 Rennes Cedex 9, France
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3
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von Deimling M, Rajwa P, Tilki D, Heidenreich A, Pallauf M, Bianchi A, Yanagisawa T, Kawada T, Karakiewicz PI, Gontero P, Pradere B, Ploussard G, Rink M, Shariat SF. The current role of precision surgery in oligometastatic prostate cancer. ESMO Open 2022; 7:100597. [PMID: 36208497 PMCID: PMC9551071 DOI: 10.1016/j.esmoop.2022.100597] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 08/31/2022] [Accepted: 09/07/2022] [Indexed: 12/30/2022] Open
Abstract
Oligometastatic prostate cancer (omPCa) is a novel intermediate disease state characterized by a limited volume of metastatic cells and specific locations. Accurate staging is paramount to unmask oligometastatic disease, as provided by prostate-specific membrane antigen-positron emission tomography. Driven by the results of prospective trials employing conventional and/or modern staging modalities, the treatment landscape of omPCa has rapidly evolved over the last years. Several treatment-related questions comprising the concept of precision strikes are under development. For example, beyond systemic therapy, cohort studies have found that cytoreductive radical prostatectomy (CRP) can confer a survival benefit in select patients with omPCa. More importantly, CRP has been consistently shown to improve long-term local symptoms when the tumor progresses across disease states due to resistance to systemic therapies. Metastasis-directed treatments have also emerged as a promising treatment option due to the visibility of oligometastatic disease and new technologies as well as treatment strategies to target the novel PCa colonies. Whether metastases are present at primary cancer diagnosis or detected upon biochemical recurrence after treatment with curative intent, targeted yet decisive elimination of disseminated tumor cell hotspots is thought to improve survival outcomes. One such strategy is salvage lymph node dissection in oligorecurrent PCa which can alter the natural history of progressive PCa. In this review, we will highlight how refinements in modern staging modalities change the classification and treatment of (oligo-)metastatic PCa. Further, we will also discuss the current role and future directions of precision surgery in omPCa.
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Affiliation(s)
- M von Deimling
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P Rajwa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Medical University of Silesia, Zabrze, Poland
| | - D Tilki
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - A Heidenreich
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, University Hospital Cologne, Cologne, Germany
| | - M Pallauf
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, University Hospital Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - A Bianchi
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - T Yanagisawa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - T Kawada
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - P I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Canada
| | - P Gontero
- Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino, Turin, Italy
| | - B Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, La Croix Du Sud Hospital, Quint-Fonsegrives, France
| | - G Ploussard
- Department of Urology, La Croix Du Sud Hospital, Quint-Fonsegrives, France
| | - M Rink
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, USA; Department of Urology, University of Texas Southwestern, Dallas, USA; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.
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4
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Yeo AE, Hendrix A, Confente C, Christian N, Mansvelt B, Pairet G, Seront E. Highlighting the Place of Metastasis-Directed Therapy in Isolated Liver Metastases in Prostate Cancer: A Case Report. Front Oncol 2021; 11:764758. [PMID: 34868986 PMCID: PMC8635688 DOI: 10.3389/fonc.2021.764758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/27/2021] [Indexed: 11/13/2022] Open
Abstract
Metastatic prostate cancer remains a challenge for clinicians. Metastases involve mainly the bone compartment and can manifest as oligometastatic disease. In this setting, the role of metastasis-directed therapies (MDT) including surgery and/or stereotactic body radiotherapy is currently evaluated. Visceral metastases are less common and have very poor prognosis in mPC. Whether treating isolated visceral metastases such as liver metastases with MDT could increase the prognosis remains unknown. We report the management of a prostate cancer patient who progressed on androgen deprivation therapy with apparition of two liver metastases. We describe the feasibility of combining MDT with abiraterone acetate and prednisone in a patient with metastatic castration-resistant prostate cancer. MDT allowed the interruption of abiraterone acetate, preventing cumulative toxicity of this agent.
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Affiliation(s)
| | - Aurore Hendrix
- Department of Medical Oncology, Jolimont Hospital, La Louvière, Belgium
| | - Caterina Confente
- Department of Medical Oncology, Jolimont Hospital, La Louvière, Belgium
| | | | | | - Géraldine Pairet
- Department of Pathology, Jolimont Hospital, La Louvière, Belgium
| | - Emmanuel Seront
- Department of Medical Oncology, Jolimont Hospital, La Louvière, Belgium
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5
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Smelzo S, Mantica G, Lucianò R, Tenace NP, De Marchi D, Pini G, Passaretti G, Losa A, Gaboardi F. Prostate cancer testicular metastasis: Are they underestimated? Case report and analysis of the literature. Urologia 2021; 89:645-647. [PMID: 33832367 DOI: 10.1177/03915603211009118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION We aim to present a rare case of a patient who developed a late testicular metastasis of PCa after radical prostatectomy. CASE DESCRIPTION A 78 years old man presenting for left testicular swelling slowly increasing of size over the last 2 months. He underwent a retropubic radical prostatectomy and extended bilateral lymphadenectomy in 2007 for prostatic adenocarcinoma. At the time of the presentation the last PSA was 0.91 ng/mL. The patient underwent a standard left orchifunicolectomy in April 2019 without intra- or perioperative complications. The pathological analysis showed a testicular metastasis of acinar adenocarcinoma. CONCLUSIONS In conclusion, testicular metastasis from PCa are uncommon conditions. PSA evaluation and physical examination of all sites of metastasis and accurate evaluation of all signs/symptoms during the clinical visit remains crucial to the diagnosis of recurrence.
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Affiliation(s)
- Salvatore Smelzo
- Department of Urology, San Raffaele Turro Hospital, San Raffaele University, Milan, Italy
| | - Guglielmo Mantica
- Department of Urology, Policlinico San Martino Hospital, University of Genova, Genova, Italy
| | - Roberta Lucianò
- Department of Pathology, San Raffaele Hospital, San Raffaele University, Milan, Italy
| | - Nazario Pio Tenace
- Department of Pathology, San Raffaele Hospital, San Raffaele University, Milan, Italy
| | - Davide De Marchi
- Department of Urology, San Raffaele Turro Hospital, San Raffaele University, Milan, Italy
| | - Giovannalberto Pini
- Department of Urology, San Raffaele Turro Hospital, San Raffaele University, Milan, Italy
| | - Giovanni Passaretti
- Department of Urology, San Raffaele Turro Hospital, San Raffaele University, Milan, Italy
| | - Andrea Losa
- Department of Urology, San Raffaele Turro Hospital, San Raffaele University, Milan, Italy
| | - Franco Gaboardi
- Department of Urology, San Raffaele Turro Hospital, San Raffaele University, Milan, Italy
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6
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Isolated Testicular Metastasis Diagnosed More than a Decade and a Half Post Primary Treatment for Prostate Cancer. Case Rep Oncol Med 2019; 2019:4956954. [PMID: 31885973 PMCID: PMC6899263 DOI: 10.1155/2019/4956954] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 11/19/2019] [Indexed: 12/03/2022] Open
Abstract
Prostate cancer is the most common visceral malignancy among men. It rarely metastasizes to the testicles. We herein present the case of a male patient who underwent a radical prostatectomy for a grade group 3 Gleason score 7 (4 + 3) prostate adenocarcinoma followed by adjuvant radiation therapy and continuous androgen deprivation therapy after his first biochemical recurrence. Despite optimal management, prostate-specific antigen (PSA) levels rose back up, upon which a PET/CT 68Gallium scan demonstrated an isolated left testicular lesion that turned out to be of prostatic origin following orchiectomy. Testicular metastases from prostate cancer are of unknown prognosis, and the current treatment modality favors an orchiectomy.
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7
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Battaglia A, Devos G, Decaestecker K, Witters M, Moris L, Van den Broeck T, Berghen C, Everaerts W, Albersen M, Tsaturyan A, De Meerleer G, Van Poppel H, Goffin K, Ost P, Tosco L, Joniau S. Metastasectomy for visceral and skeletal oligorecurrent prostate cancer. World J Urol 2019; 37:1543-1549. [DOI: 10.1007/s00345-019-02716-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 03/02/2019] [Indexed: 12/31/2022] Open
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8
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Su J, Aslim EJ, Aydin H, Tan PH, Ho HSS. A rare case of isolated castrate resistant bilateral testicular metastases in advanced prostate cancer. Asian J Urol 2018; 5:127-130. [PMID: 29736376 PMCID: PMC5934351 DOI: 10.1016/j.ajur.2017.03.001] [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] [Received: 03/01/2016] [Revised: 06/23/2016] [Accepted: 12/02/2016] [Indexed: 11/24/2022] Open
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.
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Affiliation(s)
- Jiarui Su
- Department of Urology, Singapore General Hospital, Singapore
| | | | - Hakan Aydin
- Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Puay Hoon Tan
- Division of Pathology, Singapore General Hospital, Singapore
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9
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Campara Z, Simic D, Aleksic P, Spasic A, Milicevic S. Metastasis of Prostate Adenocarcinoma to the Testis. Med Arch 2018; 70:318-320. [PMID: 27703299 PMCID: PMC5035009 DOI: 10.5455/medarh.2016.70.318-320] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 07/15/2016] [Indexed: 12/04/2022] Open
Abstract
Introduction: Prostate carcinoma is the most frequently diagnosed carcinoma in the male population. The most typical places of the metastases are pelvic lymphatic glands, bones and lungs, and very rarely it metastasizes into a testis. The prognostic importance of testicular metastasis of prostate cancer is not yet well-known, due to a very few published cases. According to the known facts, it is certain that a metastasis of the prostate carcinoma into a testis is a sign of an advanced disease. Case report: This work presents a 48-year-old patient, to whom an adenocarcinoma of the prostate has been proven by the pathohistological finding of transrectal biopsy, performed due to the elevated level of prostate-specific antigen (PSA). Nine years after the initial diagnosis, due to a gradual rise of PSA and tumorous enlargement of the left testis, left inguinal orchectomy and right orchectomy were performed. Metastatic dissemination of prostate adenocarcinoma into a testis was determined by a pathohistological analysis of the left testis. Conclusion: The metastasis of the prostate carcinoma into a testis, as a rare localization of the metastatic dissemination, after additionally performed orchectomy along with further oncological therapy, can provide a continuation of a good life quality as well as a control of the disease in a longer time period.
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Affiliation(s)
- Zoran Campara
- Clinic of Urology, Military Medical Academy (MMA), Belgrade, Serbia
| | - Dejan Simic
- Clinic of Urology, Military Medical Academy (MMA), Belgrade, Serbia
| | - Predrag Aleksic
- Clinic of Urology, Military Medical Academy (MMA), Belgrade, Serbia
| | | | - Snjezana Milicevic
- Clinic of Urology, Clinical Centre of Banja Luka, Banja Luka, Bosnia and Herzegovina
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10
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Lee KA, Mayer E, Khoo V. Painful testicular metastasis from prostate adenocarcinoma. BMJ Case Rep 2017; 2017:bcr-2017-219963. [PMID: 29212868 DOI: 10.1136/bcr-2017-219963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 60-year-old man presented with unilateral testicular pain and urinary frequency. His presenting prostate-specific antigen (PSA) was 100 ng/mL, and a biopsy revealed Gleason 4+4 prostate adenocarcinoma. The significance of his initial PSA was somewhat complicated by possible prostatitis and early initiation of bicalutamide. PSA rose on two occasions prior to radiotherapy but coincided with a flare of testicular pain on one of these. Whole-body staging diffusion-weighted MRI scan was negative. He was treated with 3 years of androgen deprivation therapy (ADT) and radical radiotherapy. PSA fell to undetectable levels on ADT. Twelve months following completion of ADT, PSA rose to 3.6 ng/mL. No disease recurrence was noted on restaging MRI pelvis. The patient was well, except for persistent testicular symptoms, which failed to resolve following multiple antibiotics. Testicular tumour markers were negative. Ultrasound findings were consistent with chronic epididymitis. A right orchidectomy was performed for symptomatic relief, confirming metastatic prostate adenocarcinoma.
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Affiliation(s)
- Karla A Lee
- Clinical Oncology, Royal Marsden NHS Foundation Trust, London, UK
| | - Erik Mayer
- Department of Urology, Imperial College Healthcare NHS Trust, London, UK.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - Vincent Khoo
- Clinical Oncology, Royal Marsden NHS Foundation Trust, London, UK
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11
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Bonetta A, Generali D, Corona SP, Cancarini G, Brenna SG, Pacifico C, Roviello G. Isolated Testicular Metastasis from Prostate Cancer. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:887-889. [PMID: 28804118 PMCID: PMC5567765 DOI: 10.12659/ajcr.904521] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Prostatic adenocarcinoma is the most frequently diagnosed carcinoma in the male population; the most common sites of secondary lesions are nodes, bones, and lungs. We report the clinical case of a 58-year-old man presenting with a single metastasis in the left testis after a radical prostatectomy/lymphadenectomy for prostate cancer. CASE REPORT This clinical report focuses on a 58-year-old man with prostate cancer who developed an uncommon single metastasis in the left testis after radical surgery and adjuvant pelvic radiation therapy. CONCLUSIONS Prostate-specific antigen (PSA) levels are important in the follow-up of prostate cancer. At the same time, physical examination of all possible sites of metastasis and proper evaluation of all signs/symptoms are indispensable in the process of identifying recurrence and for the selection of patients undergoing adjuvant therapy.
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Affiliation(s)
- Alberto Bonetta
- Department of Radiotherapy, Cremona Social and Territorial Health Company (ASST), Cremona, Italy
| | - Daniele Generali
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.,Molecular Therapy and Pharmacogenomic Unit, Cremona Social and Territorial Health Company (ASST), Cremona, Italy
| | - Silvia Paola Corona
- Peter MacCallum Cancer Centre, Department of Radiation Oncology, Moorabbin Campus, East Bentleigh, Victoria, Australia
| | | | - Sarah Grazia Brenna
- Department of Radiotherapy, Cremona Social and Territorial Health Company (ASST), Cremona, Italy
| | - Chiara Pacifico
- Department of Medical, Surgical and Neurological Sciences, University Hospital of Siena, Siena, Italy
| | - Giandomenico Roviello
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.,Department of Oncology, Medical Oncology Unit, San Donato Hospital, Arezzo, Italy
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12
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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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13
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Malik M, Joseph D, Jonnadula J, Ahmed SF, Valiyaveettil D, Vaghmare R. Bilateral Testicular Metastases and Filariasis in Prostatic Adenocarcinoma. Clin Genitourin Cancer 2016; 15:e743-e745. [PMID: 28017535 DOI: 10.1016/j.clgc.2016.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 11/10/2016] [Accepted: 11/20/2016] [Indexed: 11/25/2022]
Affiliation(s)
- Monica Malik
- Department of Radiation Oncology, Nizam's Institute of Medical Sciences, Hyderabad, India.
| | - Deepa Joseph
- Department of Radiation Oncology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Jyothi Jonnadula
- Department of Radiation Oncology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Syed Fayaz Ahmed
- Department of Radiation Oncology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Deepthi Valiyaveettil
- Department of Radiation Oncology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Rama Vaghmare
- Department of Radiation Oncology, Nizam's Institute of Medical Sciences, Hyderabad, India
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14
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Sampathrajan S, Garg G, Gupta S, Sahay SC, De S. Incidentally Detected Testicular Metastasis in a Case of Prostatic Adenocarcinoma. J Clin Diagn Res 2016; 9:ED03-4. [PMID: 26816900 DOI: 10.7860/jcdr/2015/15849.6884] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 10/08/2015] [Indexed: 11/24/2022]
Abstract
Adenocarcinoma of the prostate is one of the common cancers among elderly men worldwide. However, testicular metastasis detected incidentally after orchiectomy is a rare presentation as most commonly we encounter patients presenting with bone metastasis at the time of primary diagnosis. Here, we describe a recently diagnosed case of prostatic carcinoma that had metastasis in a single testis, incidentally detected in the orchiectomy histopathological specimen, performed for surgical castration and emphasize the importance of routine microscopical examination of the testicular specimens.
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Affiliation(s)
- Sowmiya Sampathrajan
- Senior Resident, Department of Radiation Oncology, Pushpanjali Crosslay Hospital, Galaxy Cancer Institute , Vaishali, Ghaziabad, Uttar Pradesh, India
| | - Garima Garg
- Consultant, Department of Pathology, Pushpanjali Crosslay Hospital, Galaxy Cancer Institute , Vaishali, Ghaziabad, Uttar Pradesh, India
| | - Sweety Gupta
- Consultant, Department of Radiation Oncology, Pushpanjali Crosslay Hospital, Galaxy Cancer Institute , Vaishali, Ghaziabad, Uttar Pradesh, India
| | - Shailesh Chandra Sahay
- Senior Consultant, Depatment of Urology, Pushpanjali Crosslay Hospital, Galaxy Cancer Institute , Vaishali, Ghaziabad, Uttar Pradesh, India
| | - Sudarsan De
- Senior Consultant, Department of Radiation Oncology, Pushpanjali Crosslay Hospital, Galaxy Cancer Institute , Vaishali, Ghaziabad, Uttar Pradesh, India
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Shinn BJ, Greenwald DW, Ahmad N. Unilateral testicular metastasis of low PSA level prostatic adenocarcinoma. BMJ Case Rep 2015; 2015:bcr-2015-209914. [PMID: 25994435 DOI: 10.1136/bcr-2015-209914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 71-year-old man presented with a firm left testicle 15 years after being diagnosed with prostatic adenocarcinoma. After the initial diagnosis, the patient underwent a radical prostatectomy. He received radiation therapy 5 years after surgery for a slightly elevated prostate-specific antigen (PSA) level and a negative metastatic workup. Eight years later, the patient's PSA rose to 3.38 ng/mL and he was started on intermittent Lupron therapy. It was then 3 years later when the patient discovered the testicular mass. At that time, his PSA level was 2.98 ng/mL. He underwent a left orchiectomy which demonstrated metastatic prostatic adenocarcinoma. Currently, the patient is doing well 3 months postorchiectomy and is now receiving continuous testosterone suppression therapy. This case report discusses the unique modes of spread from the prostate to the testicle as well as the importance of follow-up care in patients with prostate cancer, especially in the setting of low PSA levels.
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Affiliation(s)
| | | | - Navid Ahmad
- Department of Pathology, Wilkes Barre General Hospital, Wilkes Barre, Pennsylvania, USA
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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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Yao HH, Hong MK, Corcoran NM, Siva S, Foroudi F. Advances in local and ablative treatment of oligometastasis in prostate cancer. Asia Pac J Clin Oncol 2014; 10:308-21. [PMID: 25155557 DOI: 10.1111/ajco.12256] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2014] [Indexed: 12/31/2022]
Abstract
Oligometastasis is a state of limited metastatic disease that may be amenable to aggressive local therapy to achieve long-term survival. This review aims to explore the role of ablative radiotherapy and surgical management of prostate cancer (CaP) patients with oligometastasis. We performed a systematic review of the literature from November 2003 to November 2013 in the PubMed and EMBASE databases using structured search terms. From our literature search, we identified 13 cases of oligometastatic CaP managed by surgery. The longest disease-free survival documented was 12 years following pulmonary metastasectomy. We also found 12 studies using radiotherapy to treat oligometastatic CaP with median follow-up ranging from 6 to 43 months. Local control rates and overall survival at 3 years range from 66 to 90% and from 54 to 92%, respectively. Most patients did not report any significant toxicity. The limited current literature suggests oligometastatic CaP may be amenable to more aggressive local ablative therapy to achieve prolonged local control and delay to androgen deprivation therapy (ADT). There is a larger body of evidence supporting the use of radiotherapy than surgery in this disease state. However, no direct comparison with ADT is available to suggest an improvement in overall survival. Further studies are required to determine the role of aggressive-targeted local therapy in oligometastatic CaP.
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Affiliation(s)
- Henry Hi Yao
- Division of Urology, Department of Surgery, The University of Melbourne, Royal Melbourne Hospital, Parkville, Australia
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