Kato K, Suzuki K, Sai S, Murase T, Kobayashi Y
Department of Urology, Red Cross Nagoya First Hospital.
Hinyokika Kiyo. 1999 Dec;45(12):859-61.
A 70-year-old man, who had undergone total gastrectomy for Borrmann III gastric cancer one year previously, was referred to us with a complaint of left scrotal swelling. Physical examination showed left scrotal hydrocele and a hard nodule in the ipsilateral inguinal area. Excretory pyelography and abdominal computed tomography showed mild left hydronephrosis and no stone. A left orchiectomy was performed. The mass in the spermatic cord was 2.5 x 1.0 x 1.0 cm in size, and the pathological diagnosis was tubular adenocarcinoma, identical to that of the previous gastric cancer. Five months after orchiectomy, the patient underwent percutaneous nephrostomy to manage postrenal renal failure caused by massive metastasis of retroperitoneal lymph nodes. He died one month later. We found a total of 84 cases of metastatic tumors of the spermatic cord reported in Japan, approximately half of which were metastases from gastric cancer. In 10 cases, including ours, the tumor was accompanied by hydrocele of the scrotum or spermatic cord. Although this association is rare, cancerous lesions should be considered in the management of hydrocele.
一名70岁男性，一年前因Borrmann III型胃癌接受了全胃切除术，因左侧阴囊肿胀前来我院就诊。体格检查发现左侧阴囊鞘膜积液，同侧腹股沟区有一硬结节。排泄性肾盂造影和腹部计算机断层扫描显示左侧轻度肾积水，无结石。行左侧睾丸切除术。精索肿块大小为2.5×1.0×1.0 cm，病理诊断为管状腺癌，与之前的胃癌相同。睾丸切除术后五个月，患者因腹膜后淋巴结大量转移导致肾后性肾衰竭接受了经皮肾造瘘术。他一个月后去世。我们发现日本共报道了84例精索转移性肿瘤病例，其中约一半是胃癌转移所致。包括我们的病例在内，有10例肿瘤伴有阴囊或精索鞘膜积液。尽管这种关联罕见，但在鞘膜积液的处理中应考虑癌性病变。
