Carcinoma prostate with testicular secondaries A rare presentation

Abstract

65 years old gentleman presented with Co scrotal swelling of 7 months duration and no urinary symptoms except for increased night time frequency. He was evaluated in a private institution in Pondicherry and was found to have a huge scrotal swelling with multiple cervical lymphadenopathy . FNAC followed by biopsy of the cervical node was done which was reported as metastasis in lymphnode with the  possibility of primary from 1) Sertoli cell tumor, 2)mixed germ cell tumor, 3)prostatic adeno carcinomaThen patient came to our institution. On examination multiple cervical lymphnode and iliac group of nodes enlarged. Huge scrotal edema was present .Per rectal examination showed a hard nodular          prostate and the PSA was 1292ngml. We did a prostatic  biopsy which was reported as adenocarcinoma of prostate with Gleason score 44. M etastatic work up was done . Sr AFP, beta HcG , and LDH were normal. Bilateral   orchidectomy was done and the biopsy report came as  testicular secondary from adeno carcinoma prostate.  Immunohistochemistry was positive for prostate specific   antigen and prostate specific acid phosphotaseWe present this case report because of its rarity