Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 16, 2022; 10(32): 11974-11979
Published online Nov 16, 2022. doi: 10.12998/wjcc.v10.i32.11974
Testis and epididymis–unusual sites of metastatic gastric cancer: A case report and review of the literature
Jun-Jie Ji, Feng-Ju Guan, Yu Yao, Li-Jiang Sun, Gui-Ming Zhang
Jun-Jie Ji, Feng-Ju Guan, Yu Yao, Li-Jiang Sun, Gui-Ming Zhang, Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
Author contributions: Ji JJ and Sun LJ conceived of the report, and participated in drafting the manuscript; Guan FJ and Yao Y reviewed the pathological slides and revised the manuscript; Zhang GM supervised the project and revised the manuscript; all the authors read and approved the final version and agreed to publish the manuscript.
Supported by Natural Science Foundation of Shandong Province, No. ZR2021MH354.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this case report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gui-Ming Zhang, MD, PhD, Doctor, Department of Urology, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266003, Shandong Province, China. zhangguiming9@126.com
Received: July 18, 2022
Peer-review started: July 18, 2022
First decision: September 5, 2022
Revised: September 8, 2022
Accepted: October 18, 2022
Article in press: October 18, 2022
Published online: November 16, 2022
Abstract
BACKGROUND

Although gastric cancer is one of the most prevalent cancers worldwide, cases of gastric cancer metastasis to the male reproductive system are rare. Here, we report a case involving testicular and epididymal gastric cancer metastases.

CASE SUMMARY

A 75-year-old Chinese man complained of experiencing a palpable painful mass in the right scrotum for 6 mo. He had undergone distal gastrectomy with chemotherapy for pT3N3aMx poorly differentiated gastric adenocarcinoma 9 mo before. Physical examination revealed a moderate right hydrocele and a painful mass in the right testis and epididymis. Serum tumor biomarkers were all normal except for elevated beta-human chorionic gonadotropin levels. Computed tomography urography and B-ultrasound imaging revealed a moderate right hydrocele and a mixed solid-cystic mass in the right testicular and epididymal area. Thus, the patient underwent right radical orchiectomy. Immunohistochemical analysis revealed that the tumor cells were positive for pancytokeratins and caudal related homeodomain transcription 2. Metastatic, poorly differentiated gastric adenocarcinoma of the testis and epididymis was confirmed by pathology. He continued to undergo chemotherapy at the department of oncology of our hospital. Mesenteric lymph node metastases were found at the postoperative 1-mo follow-up.

CONCLUSION

Palpable, painful scrotal mass, history of gastric cancer, and imaging features may indicate testicular and epididymal metastatic gastric cancer.

Keywords: Gastric cancer, Testis, Epididymis, Immunohistochemistry, Metastasis, Case report

Core Tip: Cases of gastric cancer metastasis to the male reproductive system, especially both the testis and epididymis, are rare. Here, we report a 75-year-old Chinese man with testicular and epididymal gastric cancer metastases. Palpable, painful scrotal mass, history of gastric cancer, and imaging features may indicate testicular and epididymal metastatic gastric cancer.