Metastatic tumor of the spermatic cord from renal cell carcinoma

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.