A novel case of testicular metastasis from prostate cancer mimicking epididymo-orchitis despite suppressed PSA

Testicular metastasis is an uncommon complication of prostate cancer and therefore the incidence is poorly understood with the literature citing a range of incidence from 0.18% to 4%. This case report looks at a novel case of prostate cancer with testicular metastasis following good response to treatment for primary prostate cancer. The testicular lesion was found incidentally on surveillance PSMA PET CT, investigated with ultrasound and initially identified as epididymo-orchitis. The testicular lesion was later discovered on repeat imaging to be malignant in origin. Following orchidectomy it was confirmed histologically that the testicular mass was prostate in origin.