Ultrasonographic features of testicular metastasis from renal clear cell carcinoma that mimics a seminoma

Abstract

RationaleTesticular metastases from renal cell carcinoma (RCC) are extremely rare. To the best of our knowledge, only 35 cases have been described in the literatures.Patient concernsA 64-year-old male presented to our urology clinic for a palpable painless mass on his right side of the scrotum by self-examination 1 week ago, with a general abdominal ultrasonographic report showing a mass in his right kidney.Diagnoses and interventionsScrotal B-mode ultrasound revealed a 15 × 13 × 15 mm well-defined round homogenously hypoechoic nodule with a halo at the upper pole of the right testis. Color Doppler and spectral Doppler ultrasound detected abundant intranodular and perinodular blood flow signals including both arteries and veins. Malignancy was suspected. Abdominal contrast-enhanced computed tomography identified an irregular tumor in the posterior side of the right kidney, highly suspicious for renal carcinoma. The patient received right radical nephrectomy and right partial orchiectomy. Histologically, the right renal mass was diagnosed as RCC, clear cell type, grade 2. As to the right testicular mass, a metastasis from renal clear cell carcinoma was confirmed.OutcomesThe patient has lived with no recurrence for at least 17 months without adjuvant therapy.LessonsIn the case, we focus on the ultrasonographic features of the testicular metastasis from RCC. Ultrasound could provide initial and helpful information for diagnosis. When finding a mass in the testicle on the ultrasound, although most of them are primary, it is important to know whether the patient has tumor history from other parts of the body. A halo may be a special feature for metastases. Contrast-enhanced ultrasound (CEUS) and ultrasonic elastography could provide more information for differential diagnoses.

An optimal prognostic model based on gene expression for clear cell renal cell carcinoma

“…Considering that aberrant expression levels of mRNAs and lncRNAs are usually associated with the occurrence and development of ccRCC (2,(9)(10)(11)(12)(13)20), exploring further lncRNA/mRNA-based signatures to predict the prognosis in patients with ccRCC should be important. In the present study, a large quantity of RNA-sequencing and survival data of patients with ccRCC was downloaded, and DERs were screened between samples of patients with less favorable and favorable prognoses using models that could predict prognosis.…”

“…The aberrant expression of coding genes and long non-coding RNAs (lncRNA) is usually associated with the emergence and development of various types of cancers, such as lung adenocarcinoma, ovarian cancer and ccRCC, and lncRNAs could serve as potential diagnostic markers ( 4 – 8 ). It is well known that ccRCC is associated with the following: Dysregulated oxidative phosphorylation, amino acid metabolism and oncogenic metabolism, such as the downregulation of genes involved in the tricarboxylic acid cycle, decreased AMP-activated kinase and levels of PTEN protein, upregulation of the pentose phosphate pathway and glutamine transporter genes and increased acetyl-Coenzyme A carboxylase protein levels ( 2 , 9 , 10 ). lncRNAs are non-coding RNAs of >200 nucleotides in length, and numerous ccRCC-associated lncRNAs have been identified and applied as potential prognostic and diagnostic biomarkers, such as metastasis-associated lung adenocarcinoma transcript 1 and nuclear paraspeckle assembly transcript 1 ( 11 – 13 ).…”

Renal Cell Carcinoma with Testicular Metastases: A Case Report and Review of the Literature

“…In 11,157 patients with metastatic RCC, from 1998 to 2007, the most common sites of spread were to the lung (45.2%), bone (29.5%), distant lymph node (21.8%), and liver (20.3%); metastases to the testes were not noted in this study (13). To our knowledge, there have been less than 50 reported cases of RCC metastasis to the testis (17,(19)(20)(21)(22)(23)(24)(25)(26)(27).…”

Are tyrosine kinase inhibitors an effective treatment in testicular metastases from kidney cancer? Case report

“…1 The testis is an uncommon site for metastases and the most common cancer types that metastasize to the testes are prostate (35%), lung (19%), melanoma (9%), colon tumors (9%), and RCC (7%). 2 Testicular metastases are rare because the testes are "tumor sanctuary." In particular, the scrotum has a relatively low temperature, which creates an unfavorable environment for the development and spread of metastatic disease.…”

“…One proposed explanation is a retrograde venous spread via the spermatic vein. 2 This theory appears to be most plausible for ipsilateral metastasis. In case of contralateral metastasis, a possible explanation is spread via the Batson venous complex: this avalvular venous network may provide the necessary conduit between contralateral renal capsular veins and spermatic cord vessels.…”