title: Epididymal papillary cystadenocarcinoma metastasising to the testis in a patient with infertility managed with Onco-microTeSE.
abstract: Papillary cystadenomas of the epididymis are known to occur in association with Von Hippel-Lindau (VHL) disease. The development of a papillary cystadenocarcinoma, its malignant counterpart, is rare with only a few sporadic cases reported in the literature. Metastatic deposits are exceedingly uncommon; in fact, only a single case report has documented metastases to the paraureteral region, but metastases to the testis have never been reported. A 43-year-old gentleman with VHL disease presented with non-obstructive azoospermia, a right epididymal mass, and an atrophic surgically corrected undescended left testis. The epididymal mass was reported as a papillary cystadenocarcinoma on biopsy. The patient was managed with a radical inguinal orchidectomy and bench microTeSE with successful sperm retrieval. Metastatic papillary cystadenocarcinoma of the epididymis to the testis has never been previously reported. This case was managed by radical orchidectomy and subsequent onco-microTeSE, allowing safe oncological treatment and optimal fertility preservation.
authors.affiliation: Department of Urology, Guy's Hospital, London SE1 9RT, UK nishapindoria@hotmail.com.
authors.forename: Nisha
authors.initials: N
authors.lastname: Pindoria
authors.affiliation: Department of Histopathology, Guy's Hospital, London SE1 9RT, UK.
authors.forename: Yurina
authors.initials: Y
authors.lastname: Miki
authors.affiliation: Department of Urology, Guy's Hospital, London SE1 9RT, UK.
authors.forename: Andrea
authors.initials: A
authors.lastname: Tay
authors.affiliation: Department of Histopathology, Guy's Hospital, London SE1 9RT, UK.
authors.forename: Ashish
authors.initials: A
authors.lastname: Chandra
authors.affiliation: Department of Urology, St George's Hospital, London SW17 0QT, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Anderson
authors.affiliation: Department of Urology, Guy's Hospital, London SE1 9RT, UK.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Zacharakis
authors.affiliation: Department of Urology, Guy's Hospital, London SE1 9RT, UK.
authors.forename: Majed
authors.initials: M
authors.lastname: Shabbir