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Metastasis of prostate cancer to the testes is exceptionally rare. We report the case of a 67-year-old male with a 10-year history of high-risk prostate cancer, previously treated and currently in remission, who presented with left scrotal swelling. The swelling was clinically and radiologically diagnosed as a hydrocele and treated surgically.

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Introduction: Cryptorchidism impairs sperm development and increases the risk of infertility and testicular cancer. Estrogen signalling is critical for proper descent of the testicles, and hormonal imbalances play a role in cryptorchidism. CYP19, also known as aromatase, encodes an enzyme that converts testosterone, a male sex hormone, into estradiol, the main form of estrogen.

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Deep or aggressive angiomyxoma is an uncommon neoplasm of the pelvis. Although deep angiomyxoma is a benign tumor, its tendency to infiltrate soft tissues and reach a large size (typically > 10 cm) indicates aggressive biological behavior. It is usually present in female patients, but there have been recent reports of male-aggressive angiomyxoma.

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(1) Background: Testicular cancer, although accounting for only 0.5% to 1% of all solid male cancers, is the most common malignancy in males aged 15 to 35 years. Non-seminomatous germ cell tumors (NSGCT) represent nearly half of all testicular germ cell tumors and are associated with a more aggressive clinical course.

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A Rare Case of Testosterone-Producing Non-Seminoma Germ-Cell Testicular Cancer.

JCEM Case Rep

January 2025

Department of Internal Medicine, Division of Endocrinology and Diabetology, Gävle Hospital, University of Gävle, SE-80324 Gävle, Sweden.

Androgen secretion by testicular germ-cell tumors (GCTs) appears to be markedly rare and likely underreported in the literature. This case study highlights a patient with such a rare tumor, underscoring a notable and yet easily avoidable diagnostic oversight in one of the most prevalent cancers among men. We advocate for increased vigilance and the inclusion of specific symptomatic screening for hyperandrogenism of select patients in existing guidelines and, where appropriate, the implementation of standardized hormonal laboratory analyses in both pre- and post-orchidectomy assessments.

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