title: Acute scrotal pain and priapism: an early sign of progression in metastatic renal cell carcinoma?
abstract: A 43 -year-old man was treated with pazopanib for metastatic renal cell carcinoma (RCC) with imaging studies suggesting a partial response to treatment. However, the patient presented numerous times with severe testicular pain and gradually increasing priapism. He underwent an inguinal orchidectomy for symptom control. Histopathology confirmed invasion of the cord and tunica vaginalis with metastatic RCC. Further CT of the abdomen and pelvis suggested non-progression of the disease. The patient continued to develop priapism for several weeks before imaging studies confirmed disease progression; a month later the patient died. Genital involvement in metastatic RCC is unusual but should alert clinicians to the possibility of disease progression.
authors.affiliation: Department of Urology, Bart's Health NHS Trust, London, UK.
authors.forename: Kunal
authors.initials: K
authors.lastname: Patel
authors.affiliation: Department of Urology, Bart's Health NHS Trust, London, UK.
authors.forename: Benjamin W
authors.initials: BW
authors.lastname: Lamb
authors.affiliation: Department Oncology, Bart's Health NHS Trust, London, UK.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Hawkesford
authors.affiliation: Department of Urology, Bart's Health NHS Trust, London, UK.
authors.forename: John L
authors.initials: JL
authors.lastname: Peters
mesh_terms: D059787:Acute Pain / Q000209:etiology*; D000328:Adult; D002292:Carcinoma, Renal Cell / Q000473:pathology*; D003937:Diagnosis, Differential; D018450:Disease Progression; D017809:Fatal Outcome; D005834:Genital Neoplasms, Male / Q000150:complications / Q000473:pathology*; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D016609:Neoplasms, Second Primary / Q000150:complications / Q000473:pathology*; D009919:Orchiectomy; D011317:Priapism / Q000209:etiology*; D012611:Scrotum / Q000473:pathology / Q000601:surgery