Hodenmetastase eines metachronen kleinzelligen neuroendokrinen Prostatakarzinoms nach Hormontherapie eines Adenokarzinoms der Prostata

Abstract

Secondary malignant testicular tumors are rare, with the exception of infiltrations by lymphomas and leukemias. Metastases are sometimes found in cancers of the lung, gastrointestinal tract, kidney, skin and prostate. Less than about 200 cases of testicular metastasis of prostate cancer have been described in the literature. This is this a very small number in comparison to the high incidence of prostate cancer and the vast number of orchiectomies for operative hormone deprivation in advanced cases. The testicle metastases described are mostly unilateral and are often found as ductal carcinoma of the prostate. In our case, the testicular metastasis from a small cell prostate carcinoma appeared 2.5 years after androgen deprivation of an adenocarcinoma of the prostate.

Symptomatische Hodenmetastase eines azinären Adenokarzinoms der Prostata

“…Hodenmetastasen eines PCa sind meist asymptomatisch und werden überwiegend zufällig durch eine Autopsie oder nach bilateraler Orchiektomie zur hormonellen Tumorsuppression bei fortgeschrittenem PCa festgestellt [ 10 ]. Es sind nur wenige klinische Fälle dokumentiert, in Deutschland wurden bisweilen nur 4 Fälle publiziert [ 2 , 7 – 9 ]. In der Literatur wird über verschiedene mögliche Metastasierungswege diskutiert: retrograd venös, retrograd lymphatisch, arteriell embolisch, retrograd über den Ductus deferens oder durch direkte Ausbreitung [ 7 ].…”

Testicular Signet-Ring Cell Metastasis from a Carcinoma of Unknown Primary Site: A Case Report and Literature Review

“…Although the testicles are considered to be an inhospitable environment for cancer cells due to the low temperature, rarely neoplastic cells are able to invade them through the systematic venous, lymphatic circulation, or direct tumor invasion [ 14 ]. Although testicular metastases from other solid tumors have been rarely described, it is known that prostate cancer is the commonest primary tumor with such a predilection [ 15 , 16 ]. In this paper, we presented the fourth case of a CUP patient diagnosed with a metastatic scrotal lesion (see Table 1 ).…”

“…In 2004 Salesi et al reported a case of a 62-year-old man who presented with dyspnea, while a testicular mass and lung metastases with pleural effusion were noted. The final diagnosis according to the IHC studies was occult gastrointestinal adenocarcinoma [ 16 ].…”

Hodenmetastasen eines Prostatakarzinoms

“…Es kann davon ausgegangen werden, dass auch die "BlutHoden-Schranke" eine gewisse Metastasierungsbarriere darstellt, weshalb es nur in seltenen Fällen zu einer testikulä-ren Metastasierung kommt. Insbesondere bei ungewöhnlichen duktalen, neuroendokrinen oder kleinzelligen Karzinomen scheint eine Hodenmetastase durchaus möglich und sollte differenzialdiagnostisch bedacht werden [6].…”