Metastases to testis are a very rare cause of a testicular mass and may be bilateral in up to 15% of patients.
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
- testes are a 'sanctuary' site - due to the blood-testicular barrier
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.
- leukaemia (most common)
- prostate (most common solid tumor origin)
- colorectal cancer
- renal cell carcinoma
- malignant melanoma
- thyroid cancer
- esophageal adenocarcinoma
- pancreatic adenocarcinoma
- gastric carcinoma
- upper tract urothelial carcinoma
- hepatocellular carcinoma
- bladder cancer
In children, sources include:
- Wilms tumor
Testicular metastases from pancreatic carcinomas are extremely rare and are usually seen in the late phase of the disease. Fewer than 10 cases have been reported in the literature to date, all of which occurred in patients more than 50 years old.
Staging is a way of describing if and where a cancer has spread. Doctors use diagnostic tests, including CT scans and blood tests, to find out the cancer's stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and helps predict a patient's prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer.
Journal of Clinical chemistry and Laboratory Medicne