Department of Pathology, Donostia University Hospital, San Sebastian 20014, Spain.
Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA 02115, USA; Department of Pathology, Faulkner Hospital, Boston, MA 02130, USA.
Hum Pathol. 2023 Sep;139:37-46. doi: 10.1016/j.humpath.2023.06.002. Epub 2023 Jun 16.
To elucidate the spectrum of metastatic solid tumors to the testis and their clinicopathologic features. The databases and files of 26 pathology departments from 9 countries on 3 continents were surveyed to identify metastatic solid tumors to the testis and to characterize their clinicopathologic features in detail. We compiled a series of 157 cases of metastatic solid tumors that secondarily involved the testis. The mean patient age at diagnosis was 64 years (range, 12-93 years). Most patients (127/144; 88%) had clinical manifestation of the disease, with testicular mass/nodule (89/127; 70%) being the most common finding. The main mechanism of testicular involvement was metastasis in 154/157 (98%) cases. Bilateral testicular involvement was present in 12/157 (8%) patients. Concurrent or prior extratesticular metastases were present in 78/101 (77%) patients. The diagnosis was made mainly in orchiectomy specimens (150/157; 95%). Different types of carcinomas (138/157; 87%), most commonly adenocarcinoma (72/157; 46%), were the most common malignancies. The most common primary carcinomas included prostatic (51/149; 34%), renal (29/149; 20%), and colorectal (13/149; 9%). Intratubular growth was identified in 13/124 (11%) cases and paratesticular involvement was found in 73/152 (48%) cases. In patients with available follow-up (110/157; 70%), more than half (58/110; 53%) died of disease. In this largest series compiled to date, we found that most secondary tumors of the testis represent metastases from the genitourinary and gastrointestinal tract carcinomas and typically occur in the setting of disseminated disease.
为了阐明转移性实体瘤至睾丸的范围及其临床病理特征。我们调查了来自三大洲 9 个国家的 26 个病理科的数据库和档案，以确定转移性实体瘤至睾丸，并详细描述其临床病理特征。我们汇编了一系列 157 例继发性睾丸实体瘤病例。患者的平均诊断年龄为 64 岁（范围，12-93 岁）。大多数患者（127/144；88%）有疾病的临床表现，最常见的表现是睾丸肿块/结节（89/127；70%）。睾丸受累的主要机制是转移，占 157 例中的 154 例（98%）。12/157（8%）例患者存在双侧睾丸受累。78/101（77%）例患者同时或先前存在睾丸外转移。诊断主要在睾丸切除术标本中做出（150/157；95%）。不同类型的癌（138/157；87%），最常见的是腺癌（72/157；46%），是最常见的恶性肿瘤。最常见的原发性癌包括前列腺癌（51/149；34%）、肾癌（29/149；20%）和结直肠癌（13/149；9%）。在 13/124（11%）例中发现了管内生长，在 73/152（48%）例中发现了睾丸旁累及。在有可获得随访的患者中（110/157；70%），超过一半（58/110；53%）死于疾病。在迄今为止汇编的最大系列中，我们发现大多数睾丸继发性肿瘤是泌尿生殖系和胃肠道癌的转移，并且通常发生在疾病播散的情况下。
