Shinohara Mayuka, Hata Shinro, Nishida Haruto, Mimata Hiromitsu, Shin Toshitaka
Department of Urology, Faculty of Medicine, Oita University, Yufu, JPN.
Department of Diagnostic Pathology, Faculty of Medicine, Oita University, Yufu, JPN.
Cureus. 2025 Jan 11;17(1):e77304. doi: 10.7759/cureus.77304. eCollection 2025 Jan.
Testicular metastasis of a renal cell carcinoma (RCC) is extremely rare, particularly in the initial clinical presentation. Herein, we describe a unique case in which a small renal mass (pT1a RCC) initially manifested as a contralateral testicular metastasis. A 64-year-old man presented with a right intrascrotal mass. Radiology revealed multiple enlarged retroperitoneal lymph nodes and an 18-mm mass in the left kidney. Following right orchidectomy, the tumor was pathologically not of testicular origin but metastasis. Subsequently, the patient underwent robot-assisted left partial nephrectomy (RAPN) and para-aortic lymph node dissection. Histopathological analysis confirmed RCC with testicular metastasis (pT1aN1M1). Despite administration of two lines of systemic therapy, the patient died of metastatic disease 21 months after RAPN. To the best of our knowledge, this is the first documented case of a pT1a RCC presenting initially as a contralateral testicular metastasis. Our findings highlight the importance of considering metastatic RCC in the differential diagnosis of testicular masses.
肾细胞癌（RCC）的睾丸转移极为罕见，尤其是在初始临床表现时。在此，我们描述了一例独特病例，其中一个小的肾肿块（pT1a期RCC）最初表现为对侧睾丸转移。一名64岁男性因右侧阴囊内肿块就诊。影像学检查发现多个腹膜后淋巴结肿大以及左肾有一个18毫米的肿块。右侧睾丸切除术后，病理检查显示肿瘤并非起源于睾丸，而是转移瘤。随后，患者接受了机器人辅助下左肾部分切除术（RAPN）和腹主动脉旁淋巴结清扫术。组织病理学分析证实为伴有睾丸转移的RCC（pT1aN1M1）。尽管接受了两线全身治疗，患者在RAPN术后21个月死于转移性疾病。据我们所知，这是首例记录在案的pT1a期RCC最初表现为对侧睾丸转移的病例。我们的发现凸显了在睾丸肿块的鉴别诊断中考虑转移性RCC的重要性。
