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Unilateral spermatic cord metastasis from gastric cancer: a case report.

Lee KY, Park SJ, Moon SK, Kim HC - Iran J Radiol (2012)

Bottom Line: Malignant spermatic cord tumor is rare.Here we report a case of unilateral spermatic cord metastasis from advanced gastric cancer.Three years later, a painless hard palpable mass in the left inguinal area developed and the pathology revealed a spermatic cord metastasis from stomach cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Soonchunhyang University Hospital, Hoegi-dong, Republic of Korea.

ABSTRACT
Malignant spermatic cord tumor is rare. Spermatic cord metastasis is less common and the prognosis of these patients is poor. Here we report a case of unilateral spermatic cord metastasis from advanced gastric cancer. A 57-year-old male underwent total gastrectomy due to advanced gastric cancer. Three years later, a painless hard palpable mass in the left inguinal area developed and the pathology revealed a spermatic cord metastasis from stomach cancer.

No MeSH data available.


Related in: MedlinePlus

A 57-year-old male with spermatic cord metastasis from advanced gastric cancer. A, Axial contrast-enhanced CT scan showed heterogeneous enhancement and thickening of the left spermatic cord (arrow); B, Scrotal color Doppler ultrasonography revealed an irregular marginated hypoechoic mass with increased vascularity; C, The axial T2-weighted MRI showed a high-signal intensity mass within the left spermatic cord with irregular margins, and the T1-weighted image showed iso-signal intensity of the mass (which is not included in this case report); D, Coronal plane of contrast-enhanced T1-weighted image with fat-suppression showed heterogeneous enhancement (arrow); E, The gross specimen of the spermatic cord revealed an infiltrative whitish solid mass (arrow); F, The light microscope image of the spermatic cord metastasis shows typical glandular structures with malignant cells (hematoxylin and eosin stain × 100).
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fig521: A 57-year-old male with spermatic cord metastasis from advanced gastric cancer. A, Axial contrast-enhanced CT scan showed heterogeneous enhancement and thickening of the left spermatic cord (arrow); B, Scrotal color Doppler ultrasonography revealed an irregular marginated hypoechoic mass with increased vascularity; C, The axial T2-weighted MRI showed a high-signal intensity mass within the left spermatic cord with irregular margins, and the T1-weighted image showed iso-signal intensity of the mass (which is not included in this case report); D, Coronal plane of contrast-enhanced T1-weighted image with fat-suppression showed heterogeneous enhancement (arrow); E, The gross specimen of the spermatic cord revealed an infiltrative whitish solid mass (arrow); F, The light microscope image of the spermatic cord metastasis shows typical glandular structures with malignant cells (hematoxylin and eosin stain × 100).

Mentions: A 57-year-old male underwent total gastrectomy for an advanced gastric cancer (Borrmann type 2). The histology revealed poorly differentiated adenocarcinoma, penetration of the serosa and regional lymph node metastasis. The patient was followed for 3 years with no evidence of recurrence on computed tomography (CT) scans, endoscopy and PET-CT scans. Three years later, heterogeneous enhancement and thickening of the left spermatic cord was revealed on a follow-up CT scan (Figure 1A). On physical examination, a hard palpable mass was found in the left inguinal area. Ultrasonography revealed an irregular marginated, hypoechoic mass with increased vascularity (Figure 1B), left testicular swelling and mild hydrocele, which were thought to be the result of reactive change to vascular congestion. On MRI scan, the mass appeared as a diffuse thickening of the left spermatic cord with an irregular margin and high-signal intensity on the T2-weighted image, iso-signal intensity on the T1-weighted image and heterogeneous enhancement on the enhanced-T1-weighted image (Figure 1C and D). The patient underwent left radical orchiectomy. The spermatic cord showed an infiltrative solid mass on gross specimen approximately 4 × 1 cm in size (Figure 1E). The pathology revealed atypical glandular structures with malignant cells and was diagnosed as metastatic adenocarcinoma of the spermatic cord from gastric cancer (Figure 1F). The testis and epididymis were histopathologically determined to be free of carcinoma. This patient was followed up with conservative treatment. After 3 months, this patient complained of a palpable mass with pain between the left inguinal area and scrotum. Resection of this mass was performed without a preoperative imaging study. The pathologic result was “metastatic adenocarcinoma probably from the stomach”.


Unilateral spermatic cord metastasis from gastric cancer: a case report.

Lee KY, Park SJ, Moon SK, Kim HC - Iran J Radiol (2012)

A 57-year-old male with spermatic cord metastasis from advanced gastric cancer. A, Axial contrast-enhanced CT scan showed heterogeneous enhancement and thickening of the left spermatic cord (arrow); B, Scrotal color Doppler ultrasonography revealed an irregular marginated hypoechoic mass with increased vascularity; C, The axial T2-weighted MRI showed a high-signal intensity mass within the left spermatic cord with irregular margins, and the T1-weighted image showed iso-signal intensity of the mass (which is not included in this case report); D, Coronal plane of contrast-enhanced T1-weighted image with fat-suppression showed heterogeneous enhancement (arrow); E, The gross specimen of the spermatic cord revealed an infiltrative whitish solid mass (arrow); F, The light microscope image of the spermatic cord metastasis shows typical glandular structures with malignant cells (hematoxylin and eosin stain × 100).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3569555&req=5

fig521: A 57-year-old male with spermatic cord metastasis from advanced gastric cancer. A, Axial contrast-enhanced CT scan showed heterogeneous enhancement and thickening of the left spermatic cord (arrow); B, Scrotal color Doppler ultrasonography revealed an irregular marginated hypoechoic mass with increased vascularity; C, The axial T2-weighted MRI showed a high-signal intensity mass within the left spermatic cord with irregular margins, and the T1-weighted image showed iso-signal intensity of the mass (which is not included in this case report); D, Coronal plane of contrast-enhanced T1-weighted image with fat-suppression showed heterogeneous enhancement (arrow); E, The gross specimen of the spermatic cord revealed an infiltrative whitish solid mass (arrow); F, The light microscope image of the spermatic cord metastasis shows typical glandular structures with malignant cells (hematoxylin and eosin stain × 100).
Mentions: A 57-year-old male underwent total gastrectomy for an advanced gastric cancer (Borrmann type 2). The histology revealed poorly differentiated adenocarcinoma, penetration of the serosa and regional lymph node metastasis. The patient was followed for 3 years with no evidence of recurrence on computed tomography (CT) scans, endoscopy and PET-CT scans. Three years later, heterogeneous enhancement and thickening of the left spermatic cord was revealed on a follow-up CT scan (Figure 1A). On physical examination, a hard palpable mass was found in the left inguinal area. Ultrasonography revealed an irregular marginated, hypoechoic mass with increased vascularity (Figure 1B), left testicular swelling and mild hydrocele, which were thought to be the result of reactive change to vascular congestion. On MRI scan, the mass appeared as a diffuse thickening of the left spermatic cord with an irregular margin and high-signal intensity on the T2-weighted image, iso-signal intensity on the T1-weighted image and heterogeneous enhancement on the enhanced-T1-weighted image (Figure 1C and D). The patient underwent left radical orchiectomy. The spermatic cord showed an infiltrative solid mass on gross specimen approximately 4 × 1 cm in size (Figure 1E). The pathology revealed atypical glandular structures with malignant cells and was diagnosed as metastatic adenocarcinoma of the spermatic cord from gastric cancer (Figure 1F). The testis and epididymis were histopathologically determined to be free of carcinoma. This patient was followed up with conservative treatment. After 3 months, this patient complained of a palpable mass with pain between the left inguinal area and scrotum. Resection of this mass was performed without a preoperative imaging study. The pathologic result was “metastatic adenocarcinoma probably from the stomach”.

Bottom Line: Malignant spermatic cord tumor is rare.Here we report a case of unilateral spermatic cord metastasis from advanced gastric cancer.Three years later, a painless hard palpable mass in the left inguinal area developed and the pathology revealed a spermatic cord metastasis from stomach cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Soonchunhyang University Hospital, Hoegi-dong, Republic of Korea.

ABSTRACT
Malignant spermatic cord tumor is rare. Spermatic cord metastasis is less common and the prognosis of these patients is poor. Here we report a case of unilateral spermatic cord metastasis from advanced gastric cancer. A 57-year-old male underwent total gastrectomy due to advanced gastric cancer. Three years later, a painless hard palpable mass in the left inguinal area developed and the pathology revealed a spermatic cord metastasis from stomach cancer.

No MeSH data available.


Related in: MedlinePlus