Primary Testicular Cutaneous Metastasis: A Clinical and Dermoscopic Diagnostic Challenge

This article aimed to report a sporadic case of a primary testicular cutaneous metastasis, which represents a clinical and dermoscopic diagnostic challenge due to its low prevalence and non-specific dermoscopic presentation. A 24-year-old male with a history of primary non-seminomatous germ cell tumor of the left testis presented with a disseminated dermatosis characterized by raised, dome-like lesions. On dermoscopy, the lesions presented with milky-red areas, blue-white veil-like zones, multiple blood crusts, and structureless white areas. The heterogeneous morphology of the lesion raised suspicion for malignancy. A skin biopsy was performed, confirming the diagnosis of cutaneous intralymphatic infiltration by a poorly differentiated carcinoma. Cutaneous metastasis from a primary testicular tumor is exceptionally rare. Although recent efforts have improved the dermoscopic characterization of cutaneous metastases, standardized diagnostic criteria have not yet been fully established. Cutaneous metastases indicate advanced disease and carry significant prognostic implications. Such dermoscopic findings may contribute to the recognition of cutaneous signs that prompt further oncologic evaluation or suggest disease progression, particularly when clinical manifestations are misleading.