Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Endocrine Disorders
Published in: BMC Endocrine Disorders 1/2014

Open Access 01-12-2014 | Case report

Testicular and inguinal lymph node metastases of medullary thyroid cancer: a case report and review of the literature

Authors: Marialuisa Appetecchia, Agnese Barnabei, Vincenzo Pompeo, Steno Sentinelli, Roberto Baldelli, Salvatore Maria Corsello, Francesco Torino

Published in: BMC Endocrine Disorders | Issue 1/2014

Login to get access

Abstract

Background

The involvement of the testis by metastatic medullary thyroid carcinoma has never been described before. We describe the first case of metastatic medullary thyroid carcinoma affecting testis and inguinal lymph nodes.

Case presentation

A 73-year-old Caucasian man was referred to undergo urologic surgery due to a painless nodule in the right testis and an homolateral inguinal lymphoadenomegaly. The patient had a history of medullary thyroid carcinoma with relapsing disease to the spine and lung nodules. Serum calcitonin and CEA levels were 175 pg/ml and 22 ng/ml, respectively. With suspected testicular cancer, the patient underwent radical right orchiectomy with the excision biopsy of the right inguinal lymph node. Histopathology and immunohistochemistry revealed that both the lesions were due to metastases from medullary thyroid carcinoma.

Conclusion

Metastases to the testis and inguinal lymph nodes may be due to various solid and hematological tumors. This case, despite its rarity, suggests that testis and inguinal lymph nodes should be considered as potential secondary sites of medullary thyroid carcinoma as well.
Appendix
Available only for authorised users
Literature
1.
Kloos RT, Eng C, Evans DB, Francis GL, Gagel RF, Gharib H, Moley JF, Pacini F, Ringel MD, Schlumberger M, Wells SA: Medullary thyroid cancer: management guidelines of the American Thyroid Association. Thyroid. 2009, 19: 565-612. 10.1089/thy.2008.0403.CrossRefPubMed
2.
3.
Wohllk N, Cote GJ, Bugalho MM, Ordonez N, Evans DB, Goepfert H, Khorana S, Schultz P, Richards CS, Gagel RF: Relevance of RET protooncogene mutations in sporadic medullary thyroid carcinoma. J Clin Endocrinol Metab. 1996, 81: 3740-3745.PubMed
4.
Elisei R, Romei C, Cosci B, Agate L, Bottici V, Molinaro E, Sculli M, Miccoli P, Basolo F, Grasso L, Pacini F, Pinchera A: RET genetic screening in patients with medullary thyroid cancer and their relatives: experience with 807 individuals at one center. J Clin Endocrinol Metab. 2007, 92: 4725-4729. 10.1210/jc.2007-1005.CrossRefPubMed
5.
Saad MF, Ordonez NG, Rashid RK, Guido JJ, Hill CS, Hickey RC, Samaan NA: Medullary carcinoma of the thyroid. A study of the clinical features and prognostic factors in 161 patients. Medicine (Baltimore). 1984, 63: 319-342.CrossRef
6.
Pacini F, Castagna MG, Cipri C, Schlumberger M: Medullary thyroid carcinoma. Clin Oncol. 2010, 22: 475-485. 10.1016/j.clon.2010.05.002.CrossRef
7.
Börcek P, Asa SL, Gentili F, Ezzat S, Kiehl TR: Brain metastasis from medullary thyroid carcinoma. BMJ Case Rep. 2010, 29: doi:10.1136/bcr.09.2010.3301
8.
Bhatoe HS, Badwal S, Dutta V, Kannan N: Pituitary metastasis from medullary carcinoma of thyroid: case report and review of literature. J Neurooncol. 2008, 89: 63-67. 10.1007/s11060-008-9586-5.CrossRefPubMed
9.
Ricciato MP, Lombardi CP, Raffaelli M, De Rosa A, Corsello SM: Metastatic breast involvement from medullary thyroid carcinoma: a clue to consider the need of early diagnosis and adequate surgical strategy. Thyroid. 2010, 20: 831-832. 10.1089/thy.2009.0191.CrossRefPubMed
10.
Kebebew E, Ituarte PH, Siperstein AE, Duh QY, Clark OH: Medullary thyroid carcinoma: clinical characteristics, treatment, prognostic factors, and a comparison of staging systems. Cancer. 2000, 88: 1139-1148. 10.1002/(SICI)1097-0142(20000301)88:5<1139::AID-CNCR26>3.0.CO;2-Z.CrossRefPubMed
11.
Esfandiari NH, Hughes DT, Yin H, Banerjee M, Haymart MR: The Effect of Extent of Surgery and Number of Lymph Node Metastases on Overall Survival in Patients with Medullary Thyroid Cancer. J Clin Endocrinol Metab. 2014, 99: 448-454. 10.1210/jc.2013-2942.CrossRefPubMed
12.
Dottorini ME, Assi A, Sironi M, Sangalli G, Spreafico G, Colombo L: Multivariate analysis of patients with medullary thyroid carcinoma. Prognostic significance and impact on treatment of clinical and pathologic variables. Cancer. 1996, 77: 1556-1565. 10.1002/(SICI)1097-0142(19960415)77:8<1556::AID-CNCR20>3.0.CO;2-Y.CrossRefPubMed
13.
Modigliani E, Cohen R, Campos JM, Conte-Devolx B, Maes B, Boneu A, Schlumberger M, Bigorgne JC, Dumontier P, Leclerc L, Corcuff B, Guilhem I: Prognostic factors for survival and for biochemical cure in medullary thyroid carcinoma: results in 899 patients. The GETC Study Group. Groupe d’étude des tumeurs à calcitonine. Clin Endocrinol (Oxford). 1998, 48: 265-273. 10.1046/j.1365-2265.1998.00392.x.CrossRef
14.
Wells SA, Gosnell JE, Gagel RF, Moley J, Pfister D, Sosa JA, Skinner M, Krebs A, Vasselli J, Schlumberger M: Vandetanib for the treatment of patients with locally advanced or metastatic hereditary medullary thyroid cancer. J Clin Oncol. 2010, 28: 767-772. 10.1200/JCO.2009.23.6604.CrossRefPubMedPubMedCentral
15.
Torino F, Paragliola RM, Barnabei A, Corsello SM: Medullary thyroid cancer: a promising model for targeted therapy. Curr Mol Med. 2010, 10: 608-625. 10.2174/156652410792630607.CrossRefPubMed
16.
Roy M, Chen H, Sippel RS: Current understanding and management of medullary thyroid cancer. Oncologist. 2013, 18: 1093-1100. 10.1634/theoncologist.2013-0053.CrossRefPubMedPubMedCentral
17.
Haupt HM, Mann RB, Trump DL, Abeloff MD: Metastatic carcinoma involving the testis. Clinical and pathologic distinction from primary testicular neoplasms. Cancer. 1984, 54: 709-714. 10.1002/1097-0142(1984)54:4<709::AID-CNCR2820540419>3.0.CO;2-6.CrossRefPubMed
18.
Tiltman AJ: Metastatic tumours in the testis. Histopathology. 1979, 3: 31-37. 10.1111/j.1365-2559.1979.tb02979.x.CrossRefPubMed
19.
Dutt N, Bates AW, Baithun SI: Secondary neoplasms of the male genital tract with different patterns of involvement in adults and children. Histopathology. 2000, 37: 323-331. 10.1046/j.1365-2559.2000.00983.x.CrossRefPubMed
20.
Pienkos EJ, Jablokow VR: Secondary testicular tumors. Cancer. 1972, 30: 481-485. 10.1002/1097-0142(197208)30:2<481::AID-CNCR2820300228>3.0.CO;2-X.CrossRefPubMed
21.
García-González R, Pinto J, Val-Bernal JF: Testicular metastases from solid tumors: an autopsy study. Ann Diagn Pathol. 2000, 4: 59-64. 10.1016/S1092-9134(00)90012-1.CrossRefPubMed
22.
Grignon DJ, Shum DT, Hayman WP: Metastatic tumours of the testes. Can J Surg. 1986, 29: 359-361.PubMed
23.
Patel SR, Richardson RL, Kvols L: Metastatic cancer to the testes: a report of 20 cases and review of the literature. J Urol. 1989, 142: 1003-1005.PubMed
24.
Bhasin SD, Shrikhande SS: Secondary carcinoma of testis–a clinicopathologic study of 10 cases. Indian J Cancer. 1990, 27: 83-90.PubMed
25.
Sharma MC, Sudha K, Singh MK, Chahal R, Sood R: Metastatic carcinoma involving the testes. Indian J Pathol Microbiol. 1996, 39: 293-296.PubMed
26.
Lu LY, Kuo JY, Lin ATL, Chang YH, Chen KK, Pan CC, Chang LS: Metastatic Tumors Involving the Testes. J Urol ROC. 2000, 11: 12-17.
27.
Ulbright TM, Young RH: Metastatic carcinoma to the testis: a clinicopathologic analysis of 26 nonincidental cases with emphasis on deceptive features. Am J Surg Pathol. 2008, 32: 1683-1693. 10.1097/PAS.0b013e3181788516.CrossRefPubMed
28.
Nistal M, Gonzalez-Peramato P, Paniagua R: Secondary testicular tumors. Eur Urol. 1989, 16: 185-188.PubMed
29.
Hanash KA, Carney JA, Kelalis PP: Metastatic tumors to testicles: routes of metastasis. J Urol. 1969, 102: 465-468.PubMed
30.
Wang WS, Chiou TJ, Lu SH, Liu SM, Chen PM: Non-small cell lung cancer with testicular metastasis: a case report. Chin Med J (Taipei). 1996, 58: 54-57.
31.
Moore JB, Law DK, Moore EE, Dean CM: Testicular mass: an initial sign of colon carcinoma. Cancer. 1982, 49: 411-412. 10.1002/1097-0142(19820115)49:2<411::AID-CNCR2820490234>3.0.CO;2-S.CrossRefPubMed
32.
Wishami MM: Detailed anatomy of the internal spermatic vein and ovarian vein: Human cadaver study and operative spermatic venography: clinical aspects. J Urol. 1991, 145: 780-784.
33.
Price EB, Mostofi FK: Secondary carcinoma of the testis. Cancer. 1957, 10: 592-595. 10.1002/1097-0142(195705/06)10:3<592::AID-CNCR2820100326>3.0.CO;2-3.CrossRefPubMed
34.
Salesi N, Fabi A, Di Cocco B, Marandino F, Pizzi G, Vecchione A, Cognetti F: Testis metastasis as an initial manifestation of an occult gastrointestinal cancer. Anticancer Res. 2004, 24: 1093-1096.PubMed
35.
Bart J, Groen HJ, van der Graaf WT, Hollema H, Hendrikse NH, Vaalburg W, Sleijfer DT, de Vries EG: An oncological view on the blood-testis barrier. Lancet Oncol. 2002, 3: 357-363. 10.1016/S1470-2045(02)00776-3.CrossRefPubMed
36.
Mital P, Hinton BT, Dufour JM: The blood-testis and blood-epididymis barriers are more than just their tight junctions. Biol Reprod. 2011, 84: 851-858. 10.1095/biolreprod.110.087452.CrossRefPubMedPubMedCentral
37.
Huang E, Teh BS, Mody DR, Carpenter LS, Butler EB: Prostate adenocarcinoma presenting with inguinal lymphadenopathy. Urology. 2003, 61: 463-CrossRefPubMed
38.
Komeya M, Sahoda T, Sugiura S, Sawada T, Kitami K: A case of metastatic prostate adenocarcinoma to an inguinal lymph node. Central Eur J Urol. 2012, 65: 96-97.CrossRef
39.
Ismail M, Zaman F, Baithun S, Nargund V, Pati J, Masood J: Inguinal lymph node metastases from a testicular seminoma: a case report and a review of the literature. J Med Case Rep. 2010, 4: 378-10.1186/1752-1947-4-378.CrossRefPubMedPubMedCentral
40.
Corby HM, Lynch TH, Fitzpatrick JM, Smith JM: Inguinal lymph node metastases from a testicular tumor. Br J Urol. 1996, 77: 923-924. 10.1046/j.1464-410X.1996.06833.x.CrossRefPubMed
41.
42.
Barbet J, Campion L, Kraeber-Bodéré F, Chatal JF, The GTE Study Group: Prognostic impact of serum calcitonin and carcinoembryonic antigen doubling-times in patients with medullary thyroid carcinoma. J Clin Endocrinol Metab. 2005, 90: 6077-6084. 10.1210/jc.2005-0044.CrossRefPubMed
43.
Laure Giraudet A, Al Ghulzan A, Aupérin A, Leboulleux S, Chehboun A, Troalen F, Dromain C, Lumbroso J, Baudin E, Schlumberger M: Progression of medullary thyroid carcinoma: assessment with calcitonin and carcinoembryonic antigen doubling times. Eur J Endocrinol. 2008, 158: 239-246. 10.1530/EJE-07-0667.CrossRefPubMed
Metadata
Title
Testicular and inguinal lymph node metastases of medullary thyroid cancer: a case report and review of the literature
Authors
Marialuisa Appetecchia
Agnese Barnabei
Vincenzo Pompeo
Steno Sentinelli
Roberto Baldelli
Salvatore Maria Corsello
Francesco Torino
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Endocrine Disorders / Issue 1/2014
Electronic ISSN: 1472-6823
DOI
https://doi.org/10.1186/1472-6823-14-84

Other articles of this Issue 1/2014

BMC Endocrine Disorders 1/2014 Go to the issue

Research article

Depression, smoking, physical inactivity and season independently associated with midnight salivary cortisol in type 1 diabetes

Research article

A diagnostic approach for defining idiopathic remitting diabetes: a retrospective cohort study

Research article

Mental health in adolescents with Type 1 diabetes: results from a large population-based study

Research article

Contrasting effects of preexisting hyperglycemia and higher body size on hospital mortality in critically ill patients: a prospective cohort study

Case report

Ectopic insulin secreting neuroendocrine tumor of kidney with recurrent hypoglycemia: a diagnostic dilemma

Study protocol

Study protocol: a randomised placebo-controlled clinical trial to s tu dy the effect of vitamin D supplemen tation on gly caemic control in type 2 Diabetes Mellitus SUNNY trial
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits