Primary carcinoid of the testis with metastases. Case report and review of the literature.

Primary carcinoid of the testis is an extremely rare neoplasm, making up 0.23% of all testicular neoplasms. The vast majority of the reported cases are primary carcinoids and 20-25% are associated with teratomas. Approximately 10% of these tumors will develop metastases. We present a case of a 50-year-old man with a primary testicular carcinoid who developed lymph node and lung metastases 4 months after left inguinal orchidectomy. Our case was not associated with testicular teratoma or carcinoid syndrome. Vigorous efforts were done postoperatively to exclude the possibility of carcinoid tumor metastatic to the testis. Our patient achieved a mixed response (lung metastases: complete response, lymph node metastases: partial response) with combined therapy that included chemotherapy (cisplatin, etoposide, ifosfamide, epirubicin), octreotide and radiotherapy to the metastatic lymph nodes. He remains well and asymptomatic. We herein review the literature and discuss all the possibilities to explain the origin of carcinoid tumors of the testis.