Metastatic renal pelvis carcinoma to the testis: a case report and review of the literature

Metastasis from urothelial carcinoma to the testis is rare. This case report presented an extremely rare case of testicular metastasis from renal pelvis carcinoma in a 69 year old man who had experienced painless left testicular swelling, after he underwent radical nephroureterectomy and bladder cuff excision for the urothelial carcinoma of left renal pelvis ten years ago. Physical examination found a 2- to 3-cm mass in the left testicle and he was slightly tender on palpation. A scrotal ultrasound demonstrated a soft tissue mass, measuring 3.0x2.5x2.0 cm, within the left testicle. Left radical orchiectomy was performed. The pathologic diagnosis was metastatic urothelial carcinoma of the left testicle. We reviewed 12 cases of testicular metastasis from urothelial carcinoma in the existing literature in English. To our knowledge, our case is the first individual case report of testicular metastasis from renal pelvis urothelial carcinoma. We hypothesized that the most possible pathway for testicular metastasis from urothelial carcinoma is the lymphovascular system and transurethral surgery. Excision of local lesions in selected patients is suggested and may provide satisfactory management of the tumor.