Exogenous estrogen therapy, testicular cancer, and the male to female transgender population: a case report

Over the last 40 years, there has been a significant increase in the incidence of testicular cancer. The epidemiologic evidence to understand this phenomenon is unclear, however exogenous estrogen exposure is thought to be a driver in the development of testicular cancer. This is of particular impor...

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Bibliographic Details
Published in:Journal of medical case reports 2018-12, Vol.12 (1), p.373-373, Article 373
Main Authors: Chandhoke, Gursimran, Shayegan, Bobby, Hotte, Sebastien J
Format: Article
Language:English
Subjects:
Abdomen
Adult
Anticoagulants
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Back pain
Bleomycin
Cancer
Cancer metastasis
Cancer treatment
Care and treatment
Case Report
Case reports
CAT scans
Chemotherapy
Cisplatin
Diagnostic imaging
Disease Management
Epidemiology
Estrogen Replacement Therapy - adverse effects
Estrogens
Estrogens - adverse effects
Etoposide
Fatigue
Female
Glycoproteins
Health aspects
Health risk assessment
Humans
Hydronephrosis
Kidney diseases
Kinases
Lymphadenopathy
Lymphatic diseases
Male
Morbidity
Phenols (Class of compounds)
Placental hormones
Positron emission tomography
Retroperitoneal Neoplasms - drug therapy
Retroperitoneal Neoplasms - pathology
Retroperitoneal Neoplasms - secondary
Testicular cancer
Testicular dysgenesis syndrome
Testicular Neoplasms - drug therapy
Testicular Neoplasms - pathology
Thrombosis
Tomography
Transgender people
Transgender Persons
Treatment Outcome
Tumor markers
Tumors
Watchful Waiting
Withholding Treatment
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Summary:Over the last 40 years, there has been a significant increase in the incidence of testicular cancer. The epidemiologic evidence to understand this phenomenon is unclear, however exogenous estrogen exposure is thought to be a driver in the development of testicular cancer. This is of particular importance in the transgender population because utilization of exogenous estrogen therapy is an essential aspect of the transition process. We present the case of a 38-year-old Caucasian male to female transgender patient who presented with metastatic testicular cancer 15 months after initiating estrogen therapy. She presented to our emergency department with worsening back pain and fatigue. A clinical examination revealed a right-sided testicular mass. A computed tomography scan of her abdomen/pelvis identified a right groin lesion measuring 6.4 cm, a retroperitoneal mass causing right-sided hydronephrosis, an extensive deep vein thrombosis, and pathologic abdominal lymphadenopathy. Germ cell tumor markers revealed an alpha-fetoprotein of
ISSN:1752-1947
1752-1947
DOI:10.1186/s13256-018-1894-6