Bilateral secondary testicular, epididymal and spermatic cords carcinoma of prostatic origin: a case report and review of the literature

Journal of Medical Case Reports

Olusegun S. Ojo¹  Ifeoluwa S. Olorunsola¹  Amarachukwu C. Etonyeaku²  Blessing O. Lekwa³ 

[1] Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun, Nigeria;Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun, Nigeria;Mishmael Hospitals and Clinics, Akure, Ondo, Nigeria;Mishmael Hospitals and Clinics, Akure, Ondo, Nigeria;

关键词: Cancer;    Prostate;    Testes;    Metastasis;    Orchidectomy;   

DOI  :  10.1186/s13256-021-02807-4

来源: Springer

【 摘 要 】

BackgroundProstatic carcinoma is emerging as the most common male malignancy in Nigeria and the second most common male cancer worldwide. Patients often present with locally advances stages, and common sites of metastasis are the spine, pelvis, chest, and long bones. Metastases to the testes and spermatic cords are reputed to be rare and may be indicative of a worse outcome, when they occur. We recently encountered a clinical case of bilateral testicular, epididymal and spermatic cords prostatic cancer metastases.Case presentationA 71-year-old Nigerian man, who presented at our hospital with 1-month-old complaints of inability to walk together with low back and bilateral thigh pains. This presentation had been preceded by a 5-month history of lower urinary tract symptoms. On examination, the prostate was hard and nodular as were the left testis and spermatic cord. On histological assessment of a needle biopsy, prostatic adenocarcinoma (Gleason score 5 + 5 = 10) was diagnosed. A subsequent therapeutic bilateral total orchidectomy specimen was found to contain metastatic prostatic carcinoma deposits, in the testes, epididymides, and spermatic cords. Although our patient is currently doing well postoperatively on zoledronic acid, ketoconazole, bicalutamide, and tamsulosin, he is being re-evaluated periodically for any feature of recurrence.ConclusionSince it has implications for eventual outcome, every clinically suspicious therapeutic orchidectomy specimen should be subjected to a detailed histopathological examination in order to exclude secondaries from the primary prostatic malignancy.

【 授权许可】

CC BY