Metastases to testis are a very rare cause of a testicular mass and may be bilateral in up to 15% of patients.
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.
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
Etiology
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 leukemia 10.
Common 9
Very rare
In children, sources include:
- 1. Ulbright TM, Young RH. Metastatic carcinoma to the testis: a clinicopathologic analysis of 26 nonincidental cases with emphasis on deceptive features. Am. J. Surg. Pathol. 2008;32 (11): 1683-93. doi:10.1097/PAS.0b013e3181788516 - Pubmed citation
- 2. Lieng-Yi Lu, Junne-Yih Kuo, Alex T.L. Lin et al. Metastatic Tumors Involving the Testes. J Urol R.O.C., 11:12-17, 2000.
- 3. Haupt HM, Mann RB, Trump DL et-al. Metastatic carcinoma involving the testis. Clinical and pathologic distinction from primary testicular neoplasms. Cancer. 1984;54 (4): 709-14. Pubmed citation
- 4. Gillen S, Feith M, Gertler R, et al. Testicular metastasis from adenocarcinoma of the esophagus. (2009) The Annals of thoracic surgery. 87 (3): 957-9. doi:10.1016/j.athoracsur.2008.07.115 - Pubmed
- 5. Cormio L, Sanguedolce F, Massenio P, Di Fino G, Bruno M, Carrieri G. Testicular metastasis as the first clinical manifestation of pancreatic adenocarcinoma: a case report. (2015) Journal of Medical Case Reports. 9 (1): 139. doi:10.1186/s13256-015-0626-4 - Pubmed
- 6. Bo Li, Hui Cai, Zheng-Chun Kang, Hao Wu. Testicular metastasis from gastric carcinoma: A case report. (2015) World Journal of Gastroenterology. 21 (21): 6764. doi:10.3748/wjg.v21.i21.6764 - Pubmed
- 7. Manav, A Nesip, Kazan, et al. A Rare Cause of Testicular Metastasis: Upper Tract Urothelial Carcinoma. (2018) Case Reports in Urology. 2014: 759858. doi:10.1155/2014/759858 - Pubmed
- 8. Ramasamy R. Metastatic tumors to testis. (2013) Urology annals. 5 (3): 220. Pubmed
- 9. Wang CH, Yang S. Testicular metastasis from hepatocellular carcinoma. (2006) International journal of urology : official journal of the Japanese Urological Association. 13 (7): 1033-4. doi:10.1111/j.1442-2042.2006.01470.x - Pubmed
- 10. Kiely G, Kavanagh L, Bolton D, Lawrentschuk N. Urothelial carcinoma of the bladder with asynchronous metastases to both testes. (2013) Urology annals. 5 (3): 218-9. doi:10.4103/0974-7796.115743 - Pubmed
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