Testicular Metastasis as a Sanctuary Site Detected on 18F-FDG PET-CT in Disseminated Small-Cell Lung Cancer: A Diagnostic and Management Dilemma

Alok Mandal; Preeti  Sharma; Parneet Singh; Sachet Saxena

doi:10.82582/thorac.83

Authors

Alok Mandal DEPARTMENT OF NUCLEAR MEDICINE, HCG-CURIE ABDUR RAZZAQUE ANSARI CANCER INSTITUTE, RANCHI, JHARKHAND, INDIA https://orcid.org/0009-0005-6172-965X
Preeti Sharma DEPARTMENT OF OTORHINOLARYNGOLOGY, GOVERNMENT MEDICAL COLLEGE, RAJOURI, JAMMU AND KASHMIR, INDIA https://orcid.org/0009-0003-7251-6452
Parneet Singh DEPARTMENT OF NUCLEAR MEDICINE, AMERICAN INTERNATIONAL INSTITUTE OF MEDICAL SCIENCES, UDAIPUR, RAJASTHAN, INDIA https://orcid.org/0000-0003-2149-9077
Sachet Saxena DEPARTMENT OF MEDICAL ONCOLOGY, AMERICAN INTERNATIONAL INSTITUTE OF MEDICAL SCIENCES, UDAIPUR, RAJASTHAN, INDIA https://orcid.org/0000-0001-7320-7887

DOI:

https://doi.org/10.82582/thorac.83

Keywords:

Blood-Testis Barrier, Fluorodeoxyglucose F18, Positron Emission Tomography Computed Tomography, Small Cell Lung Carcinoma/diagnostic imaging, Testicular Neoplasms/ secondary

Abstract

Testicular involvement in the systemic disease is rarely encountered owing to its blood- testis barrier (BTB), making it an immune- privileged site as well as a sanctuary site. Metastasis to the testis from small- cell lung cancer (SCLC) is a rare phenomenon, typically indicating advanced systemic disease and breakdown of the BTB. We present the case of a 64- year- old male with left- sided small- cell lung cancer who underwent 18F- FDG PET- CT for staging. Staging 18F- FDG PET- CT revealed widespread nodal & skeletal metastases and an incidental hypermetabolic focus in the left testis, which was confirmed to be metastatic on HPE. This case highlights the importance of evaluating the scrotum in patients with disseminated malignancy and the potential of PET- CT to evaluate the whole body in a single study and to identify metastases even in rare sites.

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Testicular Metastasis as a Sanctuary Site Detected on 18F-FDG PET-CT in Disseminated Small-Cell Lung Cancer: A Diagnostic and Management Dilemma

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