Painful testicular metastasis from prostate adenocarcinoma

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Title: Painful testicular metastasis from prostate adenocarcinoma
Authors: Lee, KA
Mayer, E
Khoo, V
Item Type: Journal Article
Abstract: 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.
Issue Date: 5-Dec-2017
Date of Acceptance: 3-Oct-2017
ISSN: 1757-790X
Publisher: BMJ Publishing Group
Journal / Book Title: BMJ Case Reports
Volume: 2017
Copyright Statement: © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted
Sponsor/Funder: Imperial College Healthcare NHS Trust
Funder's Grant Number: UR150
Publication Status: Published
Appears in Collections:Division of Surgery
Faculty of Medicine

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