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With regard to metastatic testicular involvement, the
incidence of secondary testicular tumors ranges from 0.3%
to 3.6%. In this case, the patient had bilateral testicular
[9]
metastasis following RCC similar to simultaneous bilateral
testicular metastases from renal clear cell carcinoma.
References
a b 1. Martel CL, Lara PN. Renal cell carcinoma: current status and
Figure 1: (a) Histopathology shows malignant tumor cells arranged in large future directions. Crit Rev Oncol Hematol 2003;45:177-90.
islands and nests in the interstitium; (b) histopathology shows the seminiferous 2. Stankard CE, Karl RC. The treatment of isolated pancreatic
tubules and epididymis were pushed to one side metastases from renal cell carcinoma: a surgical review.
Am J Gastroenterol 1992;87:1658-60.
Post-operative follow-up 3. Pereira BJ, Brandão A, Borges R, Leão R, Grenha V, Coelho H,
Peralta P, Sobral F. Spermatic cord metastasis as initial presentation
Patient was followed up every 3 months in surgical OPD. of renal cell carcinoma. Acta Urol Março 2011;1:49-51.
Clinical examination routine hematological investigations 4. Göğüş C, Kiliç O, Tulunay O, Tulunay O, Bedük Y. Solitary
and abdominal ultrasound were undertaken at each visit. metastasis of renal cell carcinoma to the parotid gland 10 years
He was asymptomatic till 2 years post-operatively but is after radical nephrectomy. Int J Urol 2004;11:894-6.
now lost to follow-up. 5. Nabi G, Gania MA, Sharma MC. Solitary delayed
contralateral testicular metastasis from renal cell carcinoma.
Discussion Indian J Pathol Microbiol 2001;44:487-8.
6. Steiner G, Heimbach D, Pakos E, Müller S. Simultaneous
An unpredictable clinical behavior is often characteristic contralateral testicular metastasis from a renal clear cell
of RCC. The occurrence of metastatic localizations in carcinoma. Scand J Urol Nephrol 1999;33:136-7.
unusual sites is widely described. The interval between 7. Dieckmann KP, Düe W, Loy V. Intrascrotal metastasis of
primary diagnosis and the occurrence of distant metastasis renal cell carcinoma. Case reports and review of the literature.
Eur Urol 1988;15:297-301.
can vary from synchronous to very long. RCC 8. Tran M, Daly P, Tran T, Heathcote P. Renal cell carcinoma
[4]
metastasizing to testes is rare. Amongst the urinary tract metastases to the spermatic cord: review of the literature and
malignancies, prostate is the most common primary site case presentation. J Clin Urol 2013;6:427-31.
for testicular secondaries constituting 35% of all testicular 9. Sountoulides P, Metaxa L, Cindolo L. Atypical presentations
[5]
malignancies. The left testis is more involved than and rare metastatic sites of renal cell carcinoma: a review of
right, and it is believed that metastasis from RCC to left case reports. J Med Case Rep 2011;5:429.
[6]
testis occurs via left testicular vein. The pathogenesis of How to cite this article: Nain S, Kharkwal S, Kaur O. Metachronous
right testicular involvement is less clear and is probably metastasis of renal cell carcinoma to bilateral testis. J Cancer
of hematogenous nature by involvement of inferior vena Metastasis Treat 2015;1:39-40.
cava by invasion. Tran et al. published a rare case of Received: 11-01-2015; Accepted: 09-03-2015.
[7]
[8]
metastasis of RCC to ipsilateral spermatic cord in 2013. Source of Support: Nil, Confl ict of Interest: None declared.

40 Journal of Cancer Metastasis and Treatment ¦ Volume 1 ¦ Issue 1 ¦ April 15, 2015 ¦