British Association of

Urological Pathology

British Association of Urological Pathology

METASTATIC TUMORS

Metastases to the testis are rare in contrast to the frequency of metastatic tumors in the ovary but several recent papers have highlighted the diverse problems that testicular examples may pose. Two of these papers considered specific neoplasms with a well-known propensity for metastatic spread and resultant diagnostic problems, namely renal cell carcinoma and malignant melanoma (7, 8). In the most recent paper on the topic a review of 26 non-incidental cases of metastasis to the testis from diverse sites were described by Dr. Thomas Ulbright and myself (39). Noteworthy findings in the series just noted included the frequent absence of a known primary tumor, relative rarity of bilateral involvement, the occasional lack of a distinct testicular mass on gross examination, the infrequency of multinodularity either grossly or microscopically (common in metastasis to the ovary), the prominence of intertubular growth and conspicuous intrarete or intratubular growth in some cases. Although clinical findings are obviously helpful in some cases, in many cases it is only astute recognition by the pathologist that the microscopic picture is not typical for primary testicular disease that will lead to the appropriate workup which in some cases, particularly those of metastatic melanoma, will include immunohistochemical investigation.