Metastatic Urothelialcarcinoma to the Testis Presenting as Epididymo-Orchitis

A 70 year-old male with a complicated past urologic history including right testicular abscess requiring orchiectomy, prostate cancer, non-muscle invasive Urothelial Carcinoma (UC) of the bladder, and distal ureteral UC presented with signs and symptoms consistent with epididymo-orchitis. It was refractory to multiple prolonged courses of parenteral antibiotics as well as surgical drainage of a paratesticular fluid collection. Ultimately, orchiectomy was performed and pathologic evaluation of the testis revealed metastatic urothelial carcinoma. The testes represent a very rare metastatic location for urothelial carcinoma when there is no other evidence of systemic disease.