1- . Department of Urology, Ardabil University of Medical Sciences, Ardabil, Iran , o.majidian@arums.ac.ir
2- Department of Urology, Imam Reza Hospital, School of Medicine and Allied Medical Sciences, Ardabil University of Medical Sciences, Ardabil, Iran
2- Department of Urology, Imam Reza Hospital, School of Medicine and Allied Medical Sciences, Ardabil University of Medical Sciences, Ardabil, Iran
Abstract: (2026 Views)
Background: Metachronous testicular cancer, defined as the development of a tumor in the remaining testis, is a rare phenomenon. It is exceedingly rare when both tumors share identical histology (Seminoma) and the patient has a history of bilateral cryptorchidism. The clinical significance of this case lies in determining the optimal duration of surveillance for such patients.
Case Presentation: A 54-year-old man with a history of bilateral orchiopexy in childhood presented with a left testicular mass at age 50. He underwent left radical orchiectomy, and pathological examination revealed classical seminoma. The left testis was located in the inguinal canal. The patient was regularly followed with ultrasound for four years, during which no abnormalities were detected. At age 54, a new hypoechoic mass measuring 11×9 mm was identified in the right testis, which was also located in the inguinal canal. The patient underwent right radical orchiectomy, and pathological examination again confirmed classical seminoma with the same immunohistochemical pattern. Tumor markers remained within normal limits (LDH=347, BHCG<5, AFP=2.8).
Conclusion: Metachronous seminoma with identical histology may occur despite regular follow-up. Therefore, long-term, meticulous surveillance is essential for patients with a history of cryptorchidism and testicular cancer.
Case Presentation: A 54-year-old man with a history of bilateral orchiopexy in childhood presented with a left testicular mass at age 50. He underwent left radical orchiectomy, and pathological examination revealed classical seminoma. The left testis was located in the inguinal canal. The patient was regularly followed with ultrasound for four years, during which no abnormalities were detected. At age 54, a new hypoechoic mass measuring 11×9 mm was identified in the right testis, which was also located in the inguinal canal. The patient underwent right radical orchiectomy, and pathological examination again confirmed classical seminoma with the same immunohistochemical pattern. Tumor markers remained within normal limits (LDH=347, BHCG<5, AFP=2.8).
Conclusion: Metachronous seminoma with identical histology may occur despite regular follow-up. Therefore, long-term, meticulous surveillance is essential for patients with a history of cryptorchidism and testicular cancer.
Keywords: Testicular Neoplasms, Metachronous Neoplasms, Seminoma, Testicular Cancer, Germ Cell Tumor, Cryptorchidism, Case Reports
References
1. Shafi H, Rafati-Rahimzadeh M, Siadati S, Tahmasbipour S. Familial testicular cancer: A case report. J Mazand Univ Med Sci. 2014;23(108):138-44. [View at Publisher] [Google Scholar]
2. Smith ZL, Werntz RP, Eggener SE. Testicular Cancer: Epidemiology, Diagnosis, and Management. Med Clin North Am. 2018;102(2):251-64. [View at Publisher] [DOI] [PMID] [Google Scholar]
3. Laska MJ, Nexø BA, Vistisen K, Poulsen HE, Loft S, Vogel U. Polymorphisms in RAI and in genes of nucleotide and base excision repair are not associated with risk of testicular cancer. Cancer Lett. 2005;225(2):245-51. [View at Publisher] [DOI] [PMID] [Google Scholar]
4. Østerlind A, Berthelsen JG, Abildgaard N, Hansen SO, Hjalgrim H, Johansen B, et al. Risk of bilateral testicular germ cell cancer in Denmark: 1960-1984. J Natl Cancer Inst. 1991;83(19):1391-7. [View at Publisher] [DOI] [PMID] [Google Scholar]
5. Ghartimagar D, Ghosh A, Shrestha MK, Chettri DB, Shrestha S, Sherchan RK. Bilateral Synchronous Testicular Seminoma in a Patient with Bilateral Cryptorchidism. JNMA J Nepal Med Assoc. 2014;52(194):828-30. [View at Publisher] [DOI] [PMID] [Google Scholar]
6. Cuni X, Haxhiu I, Telegrafi S, Berisha M, Rexha N, Myftari M, et al. Metachronous Testicular Seminoma After Testicular Tumor. Gulf J Oncolog. 2018;1(27):78-81. [View at Publisher] [PMID] [Google Scholar]
7. Di Gregorio M, Nollevaux MC, Lorge F, D'Hondt L. Metachronous testicular seminoma after radiotherapy and chemotherapy: A Case Report. World J Surg Oncol. 2016:14:147. [View at Publisher] [DOI] [PMID] [Google Scholar]
8. Fossa SD, Chen J, Schonfeld SJ, McGlynn KA, McMaster ML, Gail MH, et al. Risk of contralateral testicular cancer: a population-based study of 29,515 U.S. men. J Natl Cancer Inst. 2005;97(14):1056-66. [View at Publisher] [DOI] [PMID] [Google Scholar]
9. Arda E, Cakiroglu B, Cetin G, Yuksel I. Metachronous Testicular Cancer After Orchiectomy: A Rare Case. Cureus. 2017;9(11):e1833. [View at Publisher] [DOI] [PMID] [Google Scholar]
10. Sun BL, Pearl R, Sharifi R, Guzman G. Metachronous bilateral testicular seminoma developing after an interval of 31 years: case report and review of the literature. Int J Surg Pathol. 2015;23(2):156-60. [View at Publisher] [DOI] [PMID] [Google Scholar]
11. Ettinger DS, Wood DE, Stevenson J, Aisner DL, Akerley W, Bauman JR, et al. Mesothelioma: Peritoneal, Version 2.2023, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2023;21(9):961-79. [View at Publisher] [DOI] [Google Scholar]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
