Hepatocellular Carcinoma (HCC) is the most common primary carcinoma of the liver, which mainly metastasizes through the portal vein system.
Here, we report an extremely rare case in which HCC metastasized to the capsule of an undescended testis in the right inguinal area of the patient. A tumor approximately 8.8 × 7.0 cm in size was found in the patient’s liver during a health check-up. Initially, it was considered a metastatic tumor because the patient was found to have cryptorchidism, which had been left untreated before he presented to our hospital. The patient underwent a radical orchiectomy via inguinal approach, and the resected testis in the right inguinal region was examined via microscopy. The cancer cells were arranged in nests and showed abundant red or clear cytoplasm and marked nuclear atypia. Immunohistochemical staining showed that the tumor cells were positive for CK, CK8/18, AFP, hepatocyte, GCP3, but negative for PLAP, CD10, CD30, CD34, and vimentin.
According to these findings, the tumor in the inguinal region was considered a metastatic HCC arising from the liver, rather than a seminoma that had originated in the undescended testis. We suggest that during the diagnosis of malignancies, metastatic tumors should always be considered in the differential diagnosis even if the original presentation is at rare metastatic sites or concurrent with other disease(s).
Bosman FT, Carneiro F, Hruban RH, Theise ND. WHO classification of tumors of the digestive system. 4th ed. Lyon: IRAC; 2015.
Eble JN, Sauter G, Epstein JI, Sesterhenn IA. WHO classification of tumors of the digestive system. 3rd ed. Lyon: IRAC; 2004.
Cobellis G, Noviello C, Nino F, Romano M, Mariscoli F, Martino A, Parmeggiani P, Papparella A. Spermatogenesis and cryptorchidism. Front Endocrinol (Lausanne). 2014;5:63.
Eble JN, Sauter G, Epstein JI, Sesterhenn IA. WHO classification of tumors of the urinary system and male genital organs. 3rd ed. Lyon: IRAC; 2004.
Yamauchi M, Yoshigoe F, Mera F, Ogura K, Kameda H, Nakada J, Takasaka S, Machida T, Fukunaga M. An autopsy case of double cancer (Hepatocellular carcinoma and mixed germ cell tumor of the testis)--significance of alpha-fetoprotein and human chorionic gonadotropin as tumor markers. Gan No Rinsho. 1983;29(4):A-22. 349-352
Ferri E, Pedruzzi B, Gasparin P, Lunghi M. Cervical mass as the first clinical manifestation of unsuspected metastatic seminoma. Auris Nasus Larynx. 2017. doi: https://doi.org/10.1016/j.anl.2017.07.015. [Epub ahead of print].
Salman FT, Adkins ES, Fonkalsrud EW. Morphologic effects of orchiopexy or orchiectomy on the contralateral testis in experimental unilateral cryptorchidism. Surgery. 1988;103(5):573–8. PubMed
- A metastasized hepatocellular carcinoma in the capsule of an undescended testis in the right inguinal area: report of a rare case
- BioMed Central
Neu im Fachgebiet Chirurgie
Mail Icon II