Epididymal metastasis from prostate adenocarcinoma: An unusual and challenging diagnosis suspected in gallium-68 prostate-specific membrane antigen-positron emission tomography/computed tomography and histologically confirmed

Abstract

A few cases of prostate adenocarcinoma (PCa) metastases to the epididymis have been documented in literature. We report a case of a 69-year-old man with a left epididymal metastasis, 6 years after radical prostatectomy and adjuvant radiation therapy for PCa. Although he developed biochemical recurrence, only gallium-68 prostate-specific membrane antigen-positron emission tomography/computed tomography revealed high uptake in the left testis and retrovesical space. An unrecognized painless firm nodule was palpable on the left epididymis. Radical orchiectomy was performed, and histopathological examination confirmed PCa metastasis located in the epididymis. To the best of our knowledge, this is the 27th reported case of epididymal metastasis from PCa.

Epididymal Metastasis of Cholangiocarcinoma, an Extremely Rare Event: A Case Report and Review of the Literature

“…In our case, the tumor has been in the right epididymis. In one of the previous cases, the side of the metastasis has not been reported (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13).…”

“…In 5 patients epididymal metastasis had been detected at the same time of the diagnosis of the primary cancer (2,(9)(10)(11)13). In others, this interval between the diagnosis of the primary tumor and the epididymal metastasis had been between one to 8 years (2.6 ± 2.4).…”

“…Clinical presentation of epididymal metastatic tumors have been nonspecific. In 2 patients, metastasis from prostate has been incidentally found by investigation of the source of high PSA (prostatic specific antigen) (7,13). In other patients the presenting symptoms have been scrotal mass, swelling, and tenderness (2,4,5,(7)(8)(9)11).…”

“…The most common primary carcinoma metastatic to epididymis has been prostate in 7 cases (40%) (1,3,4,7,8,10,13). Other less common primary tumors have been stomach in 2 cases (2, 6), and colon (5), jejunum (13), pancreas (12) and cholangiocarcinoma (9) each in one patient.…”

“…Both primary and metastatic cancers of the epididymis are rare (1). Epididymal metastatic carcinoma has been extremely rare and to the best of our knowledge only 13 cases have been reported (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). There has been just one reported case of cholangiocarcinoma metastatic to the epididymis and ours will be the second reported case.…”