Incidentally Found Metastatic Prostatic Carcinoma In A Therapeutic Orchiectomy Specimen.

ABSTRACT

Metastatic tumour involving the testis is a rare event. Incidental discovery of metastatic cancer in a therapeutic orchiectomy is even rarer. We report a case of metastatic adenocarcinoma prostate found incidentally in one of the bilateral therapeutic orchiectomy specimens. The patient was a 55-year-old man presenting with back ache and generalized body aches. Clinical examination showed malignant feel of prostate. Bone scan revealed metastatic disease and a serum PSA level of >100 ng/ml. Clinical diagnosis of carcinoma prostate was established and subsequent bilateral orchiectomy for hormonal deprivation was performed. On gross examination of left testis, there was a small 0.7 X 0.6 cm suspicious area. Microscopically, this area showed an infiltrating tumour in the interstitium with entrapped seminiferous tubules. Focal intravascular tumour deposit was also noted. Immunohistochemical stain for prostate-specific antigen was positive in the tumour, which confirmed the diagnosis of metastatic prostate adenocarcinoma.