Malignant melanoma representing with testicular metastasis: a case report and review of the literature

[Secondary tumors localized in testis]

Testis tumors are uncommon in oncology, and testicular metastasis from distant solid tumors are even rarer. We present two cases encountered in our department of pathology in CHU de Rennes, France. Moreover, we collected all reported cases in the Medline/PubMed databases of non-hematopoietic secondary testis tumors in adults, excluding autopsy studies, to propose an integrative study on this topic. In total, we report 98 cases of secondary testis lesions to prostate (n=38, 38.77 %), colorectal (n=19, 19.39%), gastric (n=12, 12.24%), kidney (n=7, 7.14%), lung (n=6, 6.12%) and other primary cancers. The median age at diagnosis was 66.5 years. We identified significantly more prostate adenocarcinoma (P<0.0001) when the primary tumor was known and significantly more colorectal adenocarcinoma (P=0.035) and pancreatic adenocarcinoma (P=0.002) when the primary tumor was unknown. The age at diagnosis was older when the primary tumor was known (P=0.007). We present the challenges for the diagnosis and propose some elements for diagnosis orientation. Finally, we discuss the possible ways of metastatic dissemination from primary site to testis, as illustrated by the two cases we present.

Rhabdoid melanoma in a harpy eagle (Harpia harpyja)

A 28-year-old male harpy eagle (Harpia harpyja) with a history of anorexia, hyporexia, lethargy, and progressive weight loss was found dead and submitted for post-mortem examination. Gross findings include dark brown discolouration of testes and lungs; the testes were bilaterally enlarged, glistening brown-grey to blackish in appearance, firm, smooth, and multilobulated. The lungs contained a mass with similar features to the testicles, irregularly shaped with multiple nodules. Histology of testis showed round, polygonal and pleomorphic cells, containing melanin pigments and a typical eosinophilic vacuole in their cytoplasm and with severe pleomorphism. An immunohistochemistry panel with Melan-A, vimentin, CK AE1/AE/3, MUM-1 and CD-68 were performed, yielding a positive reaction for Melan-A and vimentin. The morphology of the tumour cells, the presence of melanin pigment and the immunoreactivity for Melan-A and vimentin by the cells led to a diagnosis of rhabdoid melanoma. This is the first case of this pathology in the testis with lung metastasis in a harpy eagle.