Published online Jun 30, 2007.
https://doi.org/10.4111/kju.2007.48.6.667
Metastatic Tumor of Tunica Vaginalis Testis with Hydrocele in a Patient with Gastric Cancer
Abstract
Metastatic tumors of the tunica vaginalis testis from gastric cancer are extremely rare. We report here on a case of a 48-year-old man who had undergone total gastrectomy due to advanced gastric cancer 23 months previously, and he presented with right painless scrotal swelling. A hard mass was palpated along the right spermatic cord and there was an associated hydrocele around the mass. Ultrasonography showed homegenous hypoechoic lesions in the spermatic cord and anechoic lesion superior to the right testis, which was suggestive of hydrocele of the testis. Exploration was performed via inguinal incision. Multiple hemorrhagic small nodules were noted on the surface of the tunica vaginalis. Also, a tumor in the spermatic cord was present beyond the inner inguinal ring. On microscopic examination, adenocarcinoma cell nests, which were consistent with primary gastric cancer, were found in the tunica vaginalis testis, spermatic cord and peritesticular soft tissue, but not within the parenchyme of the testis or epididymis.
Fig. 1
Ultrasonography of the right scrotum showing tumor, hydrocele and testis.
Fig. 2
Gross specimen shows an encapsulated yellow-whitish mass, which is separated from the testis and epididymis.
Fig. 3
Metastatic tumor cells infiltrate the smooth muscle layer around the vas deferens (white arrow) (H&E, ×100).
Fig. 4
Signet ring cells are present in the fibrous tissue of the tunica vaginalis testis (H&E, ×400).
References
-
Kageyama Y, Kawakami S, Li G, Kihara K, Oshima H, Teramoto K. Metastatic tumor of spermatic cord and tunica vaginalis testis from gastric cancer: a case report. Hinyokika Kiyo 1997;43:429–431.
-
-
Kato K, Suzuki K, Sai S, Murase T, Kobayashi Y. A case of metastatic tumor of spermatic cord with hydrocele from gastric cancer. Hinyokika Kiyo 1999;45:859–861.
-
-
Kanno K, Ohwada S, Nakamura S, Ohya T, Iino Y, Morishita Y, et al. Epididymis metastasis from colon carcinoma: a case report and a review of the Japanese literature. Jpn J Clin Oncol 1994;24:340–344.
-
-
Kim MK, Kim HS, Cheon SY, Kim HJ, Jeong YB, Kim YG. Metastatic tumor of the spermatic cord from gastric cancer. Korean J Urol 2003;44:105–107.
-
-
Cricco RP, Kandzari SJ. Secondary testicular tumors. J Urol 1977;118:489–490.
-
-
Algaba F, Santaularia JM, Villavicencio H. Metastatic tumor of the epididymis and spermatic cord. Eur Urol 1983;9:56–59.
-
-
Kim HJ, Lee GH. Evaluation of the painless scrotal masses. Korean J Urol 1996;37:921–925.
-