Abstract
An alpha-fetoprotein-producing gastric cancer is rare, making up only about 3% of all gastric cancers. Further, gastric cancer with metastasis to the scrotum via a transperitoneal route is extremely rare. We report a case of metastatic scrotal mass in a 68-year-old man who had undergone a subtotal gastrectomy and gastroduodenostomy due to signet ring cell type gastric cancer with a description focusing on the radiologic findings.
Figures and Tables
Fig. 1
Ultrasonography of right scrotum.
Multilobulated and heterogeneously hyperechoic masses (M) are noted in the posterolateral aspect of testis (T) with hydrocele in the right scrotum.
![jksr-63-471-g001](/upload/SynapseData/ArticleImage/2016jksr/jksr-63-471-g001.jpg)
Fig. 2
Pelvic CT scan of right scrotum.
A. Axial CT scan image shows the lobulated and contrast-enhanced masses (arrows) along the posterolateral inner wall of right scrotum with hydrocele and congested veins.
B. Coronal reformat CT image shows the lobulated enhancing mass in the right scrotum with large amount of hydrocele. A small enhancing nodule (arrow) is also seen in the distal portion of right spermatic canal, indicating metastatic seeding nodule from peritoneal carcinomatosis.
![jksr-63-471-g002](/upload/SynapseData/ArticleImage/2016jksr/jksr-63-471-g002.jpg)
References
1. Polychronidis A, Tsolos C, Sivridis E, Botaitis S, Simopoulos C. Spermatic cord metastasis as an initial manifestation of sigmoid colon carcinoma: report of a case. Surg Today. 2002; 32:376–377.
2. Ouellette JR, Harboe-Schmidt JE, Luthringer D, Brackert S, Silberman AW. Colorectal cancer metastasis presenting as a testicular mass: case report and review of the literature. Am J Surg. 2007; 73:79–81.
3. 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.
4. Koide N, Nishio A, Igarashi J, Kajikawa S, Adachi W, Amano J. Alpha-fetoprotein-producing gastric cancer: histochemical analysis of cell proliferation, apoptosis, and angiogenesis. Am J Gastroenterol. 1999; 94:1658–1663.
5. Kono K, Amemiya H, Sekikawa T, Iizuka H, Takahashi A, Fujii H, et al. Clinicopathologic features of gastric cancers producing alphafetoprotein. Dig Surg. 2002; 19:359–365.
6. Hanash KA, Carney JA, Kelalis PP. Metastatic tumors to the testicles: routes of metastasis. J Urol. 1969; 102:465–468.
7. 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.
8. Lee J, Kang SC, Ban JH, Shin DS, Yeo JK, Yoon DH, et al. Metastatic Tumor of Tunica Vaginalis Testis with Hydrocele in a Patient with Gastric Cancer. Korean J Urol. 2007; 48:667–669.
9. Ota T, Shinohara M, Tanaka M, Date Y, Itakura H, Munakata A, et al. Spermatic cord metastases from gastric cancer with elevation of serum hCG-beta: a case report. Jpn J Clin Oncol. 2000; 30:239–240.
10. Woodward PJ, Schwab CM, Sesterhenn IA. From the archives of the AFIP: extratesticular scrotal masses: radiologic-pathologic correlation. Radiographics. 2003; 23:215–240.