Metastases to testis

Changed by Mostafa Elfeky, 1 Jul 2022

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Disclosures - updated 11 May 2022: Nothing to disclose

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Metastases to testis are a very rare cause of a testicular mass and may be bilateral in up to 15% of patients.

Epidemiology

Metastases to the testes are apparent in ~0.04% of autopsy studies in patients with known malignancy. The average age is 57 years, much older than the primary age for primary testicular cancer ².

Pathology

The literature suggests that the rarity of metastases to the testes may be due to:

lower temperature of the scrotum, so the malignant cells find it more difficult to proliferate ⁹
testes are a 'sanctuary' site - due to the blood-testicular barrier ¹⁰

Aetiology

In adults a malignant testicular lesion is much more likely to be a primary. Even so-called common sources are rare. The largest series of 20 cases of metastases to the testes, over a ten-year period, found the majority to be from leukaemia ¹⁰.