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Case Report
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| Metastatic prostate cancer to the testis as an initial presentation: Management review and outcome | ||||||
| Mathew Yamoah Kyei1, Verna Vanderpuye2, Lawrence Edusei3, James Edward Mensah4 Joel Yarney5 | ||||||
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1MBChB, FWACS, FGCS, Senior Lecturer, Department of Surgery and Urology, University of Ghana School of Medicine and Dentistry, P.O. Box 4236 Accra, Ghana.
2MBChB, FWACS, FGCPS, Radiation oncologist, and Head of Department, Radiation Oncology Department, Korle Bu Teaching Hospital. P.O. Box KB 369 Korle Bu, Accra, Ghana. 3MD, Specialist Pathologist, Department of Pathology, Korle Bu Teaching Hospital, P.O. Box 77 Korle Bu, Accra, Ghana. 4MBChB, FWACS, FGCS, Senior Lecturer, Department of Surgery and Urology, University of Ghana School of Medicine and Dentistry, P.O. Box 4236 Accra, Ghana. 5MBChB, FCRad Onc (SA), FWACS, FGPS, Radiation oncologist, Radiation Oncology Department, Korle Bu Teaching Hospital, P.O. Box KB 369 Korle Bu, Accra, Ghana. | ||||||
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| How to cite this article |
| Kyei MY, Vanderpuye V, Edusei L, Mensah JE, Yarney J. Metastatic prostate cancer to the testis as an initial presentation: Management review and outcome. Int J Case Rep Images 2016;7(7):449–453. |
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Abstract
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Introduction:
Metastatic prostate cancer to the testis as an initial presentation is a rare condition. Though it has been noted to be associated with poor prognosis, no treatment guideline is currently available aimed at improving the outcome. This report reviews the management of a case and its outcome.
Case Report: A 47-year-old male presented with a painless swelling of the left testis and rectal discomfort of three weeks duration. He had a strong family history of prostate cancer. Examination of the scrotum revealed a left non-tender testicular mass 7x5 cm that was hard with irregular surface. A digital rectal examination revealed an enlarged and nodular prostate and seminal vesicle involvement. A histological and immunohistochemical analysis of the prostatic biopsy and specimen from an inguinal orchidectomy of the left testis confirmed a metastatic prostate cancer to the testis. After three months of combined androgen deprivation therapy, he developed progressive obstructive urinary symptoms, severe pain in the anus, and a rapid increase in size of the prostate gland being castrate resistant. He underwent three dimensional conformal radiotherapy to the whole pelvis followed by seven cycles of docetaxel based chemotherapy. Nineteen months following diagnosis, his PSA was 1.86 ng/ml. Despite normal tPSA levels, there was clinical failure with development of bilateral lower limb swelling from para-aortic lymphadenopathy at two years. The patient died after two additional cycles of docetaxel chemotherapy. Conclusion: In a young patient with prostate cancer presenting initially with testicular metastasis, aggressive management strategies as pertains for castrate resistant cases need to be initiated early to improve outcomes. | |
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Keywords:
Androgen deprivation, Chemotherapy, Metastasis, Prostate cancer, Radiation, Testis
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Author Contributions
Mathew Yamoah Kyei – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Verna Vanderpuye – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Lawrence Edusei – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published James Edward Mensah – Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published Joel Yarney – Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2016 Mathew Yamoah Kyei et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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