title: Testicular metastasis as the first clinical manifestation of pancreatic adenocarcinoma: a case report.
abstract: BACKGROUND
  Testicular metastases from pancreatic carcinomas are extremely rare and are usually seen in the late phase of the disease. Fewer than 10 cases have been reported in the literature to date, all of which occurred in patients more than 50 years old. Herein we describe the first case, to our knowledge, of testicular metastasis as the first clinical manifestation of pancreatic carcinoma in a young adult.
  
  
  METHODS
  A 36-year-old Caucasian man presented to our institution with an acutely developed severe pain in his right testis. His clinical examination and scrotal ultrasounds were consistent with a tumor involving the entire right testis. The patient underwent radical orchiectomy. His pathologic examination revealed the tumor to be a metastasis from a pancreatic cancer that was confirmed by an abdominal computed tomographic scan.
  
  
  CONCLUSIONS
  The present case shows that testicular metastasis could be the presenting sign of metastatic pancreatic cancer and that testicular metastases from solid organ tumors, though typical of elderly people, may occasionally be seen in young adults as well.
authors.affiliation: Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy. luigicormio@libero.it.
authors.forename: Luigi
authors.initials: L
authors.lastname: Cormio
authors.affiliation: Department of Pathology, University of Foggia, Foggia, Italy. fradolce@hotmail.com.
authors.forename: Francesca
authors.initials: F
authors.lastname: Sanguedolce
authors.affiliation: Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy. p.massenio@alice.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Massenio
authors.affiliation: Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy. giuseppe_difino@libero.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Fino
authors.affiliation: Department of Pathology, Madonna delle Grazie Hospital, Matera, Italy. maria.bruno@asmbasilicata.it.
authors.forename: Mariantonietta
authors.initials: M
authors.lastname: Bruno
authors.affiliation: Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy. giuseppe.carrieri@unifg.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Carrieri
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000556:secondary*; D000328:Adult; D006801:Humans; D008297:Male; D009919:Orchiectomy; D010190:Pancreatic Neoplasms / Q000473:pathology*; D013736:Testicular Neoplasms / Q000556:secondary*; D014057:Tomography, X-Ray Computed