Renal Cell Carcinoma with Testicular Metastases: A Case Report and Review of the Literature

Main Article Content

Sho Yoshitake
Brian M. Shinder
Kevin Dazen
Colton Smith
Tina M. Mayer
Evita Sadimin
Eric A. Singer


clear cell, metastatic renal cell carcinoma, renal cell carcinoma, systemic therapy, testicular mass


Renal cell carcinoma (RCC) metastases to the testicle are an extremely rare clinical entity. Here, we describe the case of a man with metastatic RCC who developed a new testicular mass. Pathologic analysis after surgical removal of this testicle confirmed the diagnosis of metastatic RCC. This report highlights the unique diagnostic and therapeutic challenges associated with such a disease process.

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1. Capitanio U, Bensalah K, Bex A, Boorjian SA, Bray F, Coleman J, et al. Epidemiology of renal cell carcinoma. Eur Urol. 2019;75(1):74–84. 10.1016/j.eururo.2018.08.036

2. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2021. CA Cancer J Clin. 2021;71(1):7–33. 10.3322/caac.21654

3. Skinner DG, Colvin RB, Vermillion CD, Pfister RC, Leadbetter WF. Diagnosis and management of renal cell carcinoma A clinical and pathologic study of 309 cases. Cancer. 1971;28(5):1165–77. 10.1002/1097-0142(1971)28:5%3C1165::AID-CNCR2820280513%3E3.0.CO;2-G

4. Uzzo RG, Cherullo EE, Myles J, Novick RC. Renal cell carcinoma invading the urinary collecting system: implications for staging. 2002;167(6):2392-6. 10.1097/00005392-200206000-00012

5. Schefft P, Novick AC, Straffon, RA, Steward BH. Surgery for renal cell carcinoma extending into the inferior vena cava. 1978;120(1):28-31. 10.1016/s0022-5347(17(57028-75

6. Kane CJ, Mallin K, Ritchey J, Cooperberg MR, Carroll PR. Renal cell cancer stage migration: Analysis of the National Cancer Data Base. Cancer. 2008;113(1):78–83. 10.1002/cncr.23518

7. Van Poppel H, Da Pozzo L, Albrecht W, Matveev V, Bono A, Borkowski A, et al. A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma. Eur Urol. 2011;59(4):543–52. 10.1016/j.eururo.2010.12.013

8. Shinder BM, Rhee K, Farrell D, Farber NJ, Stein MN, Jang TL, et al. Surgical management of advanced and metastatic renal cell carcinoma: A multidisciplinary approach. Front Oncol. 2017;7:107. 10.3389/fonc.2017.00107

9. Gupta K, Miller JD, Li JZ, Russell MW, Charbonneau C. Epidemiologic and socioeconomic burden of metastatic renal cell carcinoma (mRCC): A literature review. Cancer Treat Rev. 2008;34(3):193–205. 10.1016/j.ctrv.2007.12.001

10. Janzen NK, Kim HL, Figlin RA, Belldegrun AS. Surveillance after radical or partial nephrectomy for localized renal cell carcinoma and management of recurrent disease. Urol Clin North Am. 2003;30(4):843–52. 10.1016/S0094-0143(03)00056-9

11. Dreyfuss LD, Master VA, Raman JD, Spiess PE, Wells SA, Merrill SB, et al. Patterns of initial metastatic recurrence after surgery for high-risk nonmetastatic renal cell carcinoma. Urology. 2020;146:152–7. 10.1016/j.urology.2020.07.045

12. Kalra S, Atkinson BJ, Matrana MR, Matin SF, Wood CG, Karam JA, et al. Prognosis of patients with metastatic renal cell carcinoma and pancreatic metastases. BJU Int. 2016;117(5):761–5. 10.1111/bju.13185

13. Bianchi M, Sun M, Jeldres C, Shariat SF, Trinh QD, Briganti A, et al. Distribution of metastatic sites in renal cell carcinoma: A population-based analysis. Ann Oncol. 2012;23(4):973–80. 10.1093/annonc/mdr362

14. Sountoulides P, Metaxa L, Cindolo L. Atypical presentations and rare metastatic sites of renal cell carcinoma: A review of case reports. J Med Case Rep. 2011;5:429. 10.1186/1752-1947-5-429

15. Morita Y, Iwagami T, Kawakita C, Kusuyama Y, Niki-Yonekawa A, Morita N. Oral metastasis of renal cell carcinoma mimicking recurrence of excised malignant myoepithelioma: A case report. Mol Clin Oncol. 2018;9(1):66–9. 10.3892/mco.2018.1630

16. Wang G. Metastatic carcinoma to the testis-a mini review. J Rare Dis Res Treat. 2019;4(2):16–22. 10.29245/2572-9411/2019/2.1177

17. Wang G, Zhou C, Villamil CF, So A, Yuan R, English JC, et al. Metastatic renal cell carcinoma to the testis: A clinicopathologic analysis of five cases. Case Rep Pathol. 2020;2020:9394680. 10.1155/2020/9394680

18. García-González R, Pinto J, Val-Bernal JF. Testicular metastases from solid tumors: An autopsy study. Ann Diagn Pathol. 2000;4(2):59–64. 10.1016/S1092-9134(00)90012-1

19. Moriyama S, Takeshita H, Adachi A, Arai Y, Higuchi S, Tokairin T, et al. Simultaneous bilateral testicular metastases from renal clear cell carcinoma: A case report and review of the literature. Oncol Lett. 2014;7(4):1273–5. 10.3892/ol.2014.1830

20. Marzouk K, Alyami F, Merrimen J, Bagnell S. Metastatic renal cell carcinoma to the testis: A case report and review of the literature. Can Urol Assoc J. 2014;8(11–12):E924–7. 10.5489/cuaj.2209

21. Dell’Atti L. Unusual ultrasound presentation of testicular metastasis from renal clear cell carcinoma. Rare Tumors. 2016;8(3):6471. 10.4081/rt.2016.6471

22. Kongnyuy M, Lawindy S, Martinez D, Parker J, Hall M. A rare case of the simultaneous, multifocal, metastatic renal cell carcinoma to the ipsilateral left testes, bladder, and stomach. Case Rep Urol. 2016;2016:1829025. 10.1155/2016/1829025

23. Reekhaye A, Sakthivel A, Nagarajan S, Gowda R. Metachronous bilateral testicular metastases from renal cell carcinoma: A case report. J Clin Urol. 2017;10(3):241–4. 10.1177/2051415815607420

24. Rouvinov K, Neulander EZ, Kan E, Asali M, Ariad S, Mermershtain W. Testicular metastasis from renal cell carcinoma: A case report and review of the literature. Case Rep Oncol. 2017;10(1):388–91. 10.1159/000473698

25. Huang H, Ling W, Qiu T, Luo Y. Ultrasonographic features of testicular metastasis from renal clear cell carcinoma that mimics a seminoma: A case report. Medicine (Baltimore). 2018;97(40):e12728. 10.1097/MD.0000000000012728

26. De Gobbi A, Mangano MS, Cova G, Lamon C, Maccatrozzo L. Testicular metastasis from renal cell carcinoma after nephrectomy and on tyrosine kinase inhibitors therapy: Case report and review. Urol J. 2019;86(2):96–8. 10.1177/0391560318818951

27. Kolukcu E, Kilic S, Parlaktas BS, Deresoy FA, Atilgan D, Gumusay O, et al. Contralateral testicular metastasis of renal cell carcinoma: A case report. Eurasian J Med. 2019;51(3):310–12. 10.5152/eurasianjmed.2018.18357

28. Steiner G, Heimbach D, Pakos E, Müller S. Simultaneous contralateral testicular metastasis from a renal clear cell carcinoma. Scand J Urol Nephrol. 1999;33(2):136–7. 10.1080/003655999750016168

29. Camerini A, Tartarelli G, Martini L, Donati S, Puccinelli P, Amoroso D. Ipsilateral right testicular metastasis from renal cell carcinoma in a responder patient to interleukine-2 treatment. Int J Urol. 2007;14(3):259–60. 10.1111/j.1442-2042.2007.01674.x

30. Ulbright TM, Young RH. Metastatic carcinoma to the testis: A clinicopathologic analysis of 26 nonincidental cases with emphasis on deceptive features. Am J Surg Pathol. 2008;32(11):1683–93. 10.1097/PAS.0b013e3181788516

31. Park JS, Kim J, Elghiaty A, Ham WS. Recent global trends in testicular cancer incidence and mortality. Medicine (Baltimore). 2018;97(37):e12390. 10.1097/MD.0000000000012390

32. Winter C, Albers P. Testicular germ cell tumors: Pathogenesis, diagnosis and treatment. Nat Rev Endocrinol. 2011;7(1):43–53. 10.1038/nrendo.2010.196

33. Spermon JR, Witjes JA, Kiemeney LALM. Difference in stage and morphology-adjusted survival between young and elderly patients with a testicular germ cell tumor. Urology. 2002;60(5):889–93. 10.1016/S0090-4295(02)01886-1

34. Ruf CG, Isbarn H, Wagner W, Fisch M, Matthies C, Dieckmann K-P. Changes in epidemiologic features of testicular germ cell cancer: Age at diagnosis and relative frequency of seminoma are constantly and significantly increasing. Urol Oncol. 2014;32(1):33.e1–.e6. 10.1016/j.urolonc.2012.12.002

35. Shaw J. Diagnosis and treatment of testicular cancer. Am Fam Phys. 2008;77(4):469–74.

36. Gilligan T, Lin DW, Aggarwal R, Chism D, Cost N, Derweesh IH, et al. Testicular cancer, version 2.2020, NCCN clinical practice guidelines in oncology. J Natl Compreh Cancer Netw. 2019;17(12):1529–54. 10.6004/jnccn.2019.0058

37. Zuniga A, Lawrentschuk N, Jewett MAS. Organ-sparing approaches for testicular masses. Nat Rev Urol. 2010;7(8):454–64. 10.1038/nrurol.2010.100

38. Ljungberg B, Albiges L, Abu-Ghanem Y, Bensalah K, Dabestani S, Fernández-Pello S, et al. European association of urology guidelines on renal cell carcinoma: The 2019 update. Eur Urol. 2019;75(5):799–810. 10.1016/j.eururo.2019.02.011

39. Monteiro FSM, Soares A, Debiasi M, Schutz FA, Maluf FC, Bastos DA, et al. First-line treatment of metastatic renal cell carcinoma in the immuno-oncology era: Systematic review and network meta-analysis. Clin Genitour Cancer. 2020;18(4):244–51.e4. 10.1016/j.clgc.2020.02.012

40. Khetani VV, Portal DE, Shah MR, Mayer T, Singer EA. Combination drug regimens for metastatic clear cell renal cell carcinoma. World J Clin Oncol. 2020;11(8):541–62. 10.5306/wjco.v11.i8.541