Spermatic Cord Metastasis of Primary Hepatocellular Carcinoma Presenting as an Inguinal Mass: A Case Report

Abstract

Most spermatic cord masses are benign, and malignant spermatic cord tumors are uncommon. Spermatic cord metastases originating from hepatocellular carcinoma (HCC) have not been previously reported in the English language literature as determined by a PubMed search. We report a male patient who presented with a painful palpable mass in the right inguinal area. The patient was diagnosed with HCC in 2004 and undertook a nonsurgical approach to control the cancer. A radical orchiectomy was performed, and the pathological report showed metastatic HCC in the spermatic cord. The patient received palliative radiation therapy because of a positive surgical margin. No recurrence was noted after 6 months of followup.

Right inguinal metastasis from hepatocellular carcinoma

“…In contrast, bone metastases (the top three metastatic sites of HCC) often cause severe pain and a deteriorated quality of life that could be clearly identified by the patients 5 . Metastasis of HCC in the groin region is extremely rare; and only two cases have been reported till now 7,8 . Although it is not causing much pain for our patient, the metastatic HCC at groin was easily observed due to its apparent bulging.…”

“…5 Metastasis of HCC in the groin region is extremely rare; and only two cases have been reported till now. 7,8 Although it is not causing much pain for our patient, the metastatic HCC at groin was easily observed due to its apparent bulging. However, malignant tumors within the inguinal hernia sac were rare and the reported incidence was only 0.4% to 0.5% among the cases with excision.…”

A metastasized hepatocellular carcinoma in the capsule of an undescended testis in the right inguinal area: report of a rare case

“…Cancer cells may be involved in the inguinal area after invading the peritoneum first. HCC metastasis to the inguinal area is also rare and only one case of an HCC that had metastasized to the spermatic cord of the inguinal region has been reported [ 15 ]. In this particular case, the HCC also metastasized to the inguinal region, where the undescended testis co-localized.…”

Incidental detection of urinary bladder herniation in 18F-fluorodeoxyglucose positron emission tomography/computed tomography mimicking as metastatic deposit in the inguinal canal

“…Metastatic deposits from HCC in the inguinal canal, although uncommon, are not very rare. [12] Apart from metastatic deposits and rare spermatic cord malignancies,[3] inflammation in the herniated bowel loops, postsurgical mesh repair at the inguinal canal,[4] missed ectopic testis,[5] and as in this case an undiagnosed bladder herniation are the potential pitfalls of 18F-FDG PET/CT in the evaluation for metastasis[67] in the inguinal canal. Although urinary bladder accounts for only ~1%–4% of inguinal canal herniation,[8] suspicion should be held to avoid misinterpretation, leading to false-positive results.…”