Gohji K, Nakanishi T, Yoshimura K, Kamidono S
Department of Urology, Kobe University School of Medicine.
Hinyokika Kiyo. 1990 Jul;36(7):827-9.
A 56-year-old male visited our hospital with macroscopic hematuria. Physical and X-ray examinations showed he had right renal cell carcinoma with tumor thrombosis in the inferior vena cava and the right spermatic vein. Radical nephrectomy and tumor thrombectomy were performed and he was discharged with no evidence of disease 1 month after the operation. At 5 months after the discharge, he noticed a palpable mass in the scrotum. Right orchiectomy was performed. The tumor was located in the right spermatic cord and histological examination revealed it to be a renal cell carcinoma (clear cell subtype) which was a metastatic lesion from a right renal tumor. In this case, the renal cell carcinoma was considered to have retrogradely metastasized through the spermatic vein. In conclusion, a complete physical examination, including the spermatic cord is recommended during the follow-up period of renal cell carcinoma.
一名56岁男性因肉眼血尿前来我院就诊。体格检查和X线检查显示，他患有右肾细胞癌，下腔静脉和右精索静脉有肿瘤血栓形成。行根治性肾切除术和肿瘤血栓切除术，术后1个月出院，无疾病迹象。出院后5个月，他发现阴囊内有一个可触及的肿块。行右侧睾丸切除术。肿瘤位于右侧精索，组织学检查显示为肾细胞癌（透明细胞亚型），是右肾肿瘤的转移灶。在这种情况下，肾细胞癌被认为是通过精索静脉逆行转移的。总之，在肾细胞癌的随访期间，建议进行包括精索在内的全面体格检查。
