Rare testicular metastasis of urothelial carcinoma: case report
DOI: 10.22591/magyurol.2026.2.marvanykovif.80
Authors:
Márványkövi Fanni Magdolna dr.1, Bartek Virág dr.2, Gonda Gábor dr.3,
Sükösd Farkas dr.3, Biró Krisztina dr.4, Beöthe Tamás dr.1
1Budapesti Péterfy Sándor Utcai Kórház-Rendelőintézet, Urológiai Osztály, Budapest
2Nógrád Vármegyei Szent Lázár Kórház-Rendelőintézet, Urológiai Osztály, Salgótarján
3Budapesti Péterfy Sándor Utcai Kórház-Rendelőintézet, Pathológia Osztály, Budapest
4Országos Onkológiai Intézet, Urogenitális Tumorok és Klinikai Farmakológiai Osztály, Budapest
Summary
Urothelial carcinoma most commonly metastasizes to regional lymph nodes, lungs, liver, and bone, while testicular involvement is extremely rare.
We present a 70-year-old male admitted due to symptomatic right-sided hydrocele with a history of previously treated high-grade bladder urothelial carcinoma. Physical examination and ultrasound showed no suspicion of malignancy; however, intraoperative findings revealed extensive fibrotic alteration and semicastration was performed. Histopathological and immunohistochemical analysis confirmed metastatic urothelial carcinoma with high PD-L1 expression. Subsequent staging detected additional lymph node metastases, therefore platinum-based chemotherapy followed by maintenance immune checkpoint inhibitor therapy was initiated. Due to significant cardiovascular comorbidities, the patient was managed under cardio-oncological supervision, allowing safe administration of oncological treatments.
This case highlights that unusual metastatic sites may appear years after primary treatment of urothelial carcinoma and that apparently benign scrotal lesions may conceal malignancy. Accurate diagnosis relies on intraoperative assessment and immunohistochemical evaluation.