Metastatic Tumors in Testis : Routes of Spread
Routes of Spread: Metastases can reach the testis via a variety of routes: retrograde venous extension via spermatic vein, arterial embolism, retrograde extension via lymphatics from para-aortic lymph nodes, intraductal through vas deferens lumen, transperitoneal (if processus vaginalis is patent), and direct spread. The image shows metastatic prostatic adenocarcinoma in a testis. The growth pattern is predominantly interstitial (in between seminiferous tubules). The patient had a long-standing history of prostatic adenocarcinoma (Gleason score 4+5=9; Grade group 5). The tumor was strongly immunoreactive for PSA and PSAP.