RT Journal Article
SR Electronic
T1 Painful testicular metastasis from prostate adenocarcinoma
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr-2017-219963
DO 10.1136/bcr-2017-219963
VO 2017
A1 Karla A Lee
A1 Erik Mayer
A1 Vincent Khoo
YR 2017
UL http://casereports.bmj.com/content/2017/bcr-2017-219963.abstract
AB A 60-year-old man presented with unilateral testicular pain and urinary frequency. His presenting prostate-specific antigen (PSA) was 100 ng/mL, and a biopsy revealed Gleason 4+4 prostate adenocarcinoma. The significance of his initial PSA was somewhat complicated by possible prostatitis and early initiation of bicalutamide. PSA rose on two occasions prior to radiotherapy but coincided with a flare of testicular pain on one of these. Whole-body staging diffusion-weighted MRI scan was negative. He was treated with 3 years of androgen deprivation therapy (ADT) and radical radiotherapy. PSA fell to undetectable levels on ADT. Twelve months following completion of ADT, PSA rose to 3.6 ng/mL. No disease recurrence was noted on restaging MRI pelvis. The patient was well, except for persistent testicular symptoms, which failed to resolve following multiple antibiotics. Testicular tumour markers were negative. Ultrasound findings were consistent with chronic epididymitis. A right orchidectomy was performed for symptomatic relief, confirming metastatic prostate adenocarcinoma.