title: Testicular metastases: a poor prognostic factor in patients with advanced prostate cancer.
abstract: OBJECTIVE
  Prostate cancer is the most frequently diagnosed neoplasm in men. In some patients, however, the disease pursues a clearly more aggressive course. Testicular metastases from prostate cancer are rare events that have been previously reported; however, its frequency and clinical meaning are not well established. The aim of the present study was, therefore, to evaluate its occurrence and clinical meaning.
  
  
  METHODS
  A review of patients who underwent androgen deprivation orchidectomy for prostate cancer between 1995 and 2007 was undertaken. On the period evaluated, 1,693 orchidectomies were performed at our institution. Since, the population of patients treated at our institution does not have access to the expensive androgen-deprivation drugs, the vast majority is treated through surgical castration. In such context, evaluation of testicular parenchyma of patients with advanced prostate cancer could be assessed. Clinical and histological data were reviewed, and patients with testicular metastases were identified.
  
  
  RESULTS
  Of the 1,693 orchidectomies performed during the period analysed, three cases of testicular metastases of prostate cancer (range 58-76 years) were diagnosed (0.18%). All patients had very atypical neoplasm's behaviour and poor prognosis, dying within the first year.
  
  
  CONCLUSIONS
  In conclusion, testicular metastases from prostate cancer are a rare event, observed in 1.8 per 1,000 cases. As other visceral metastases, testicular metastases might also be considered as an unusual additional factor of poor prognosis.
authors.affiliation: Division of Urology, Medical School of Santa Casa of Sao Paulo, São Paulo, Brazil. fkorkes@terra.com.br
authors.forename: Fernando
authors.initials: F
authors.lastname: Korkes
authors.forename: Renato
authors.initials: R
authors.lastname: Gasperini
authors.forename: Karen Levy
authors.initials: KL
authors.lastname: Korkes
authors.forename: Deusdedit Cortez Vieira
authors.initials: DC
authors.lastname: Silva Neto
authors.forename: Marilia Germanos
authors.initials: MG
authors.lastname: Castro