A case of pancreatic adenocarcinoma diagnosed with scrotal enlargement due to left varicocele testis following infiltration of the left renal vein

• Published in: Suizo Vol. 39; no. 2; pp. 167 - 171
• Main Authors: TOKUHASHI, Naruhiko, YOSHINO, Jun, ISHIHARA, Kei, IGAKI, Takahiro, OGO, Taichi, NAGANO, Hiroto, KATO, Shunsuke, IRIE, Takumi, INOKUCHI, Mikito
• Format: Journal Article
• Language: Japanese
• Published: Japan Pancreas Society 30.04.2024
• Subjects: Inguinal bulge; Inguinal hernia; Pancreatic adenocarcinoma; Varicocele testis
• ISSN: 0913-0071; 1881-2805
• DOI: 10.2958/suizo.39.167

A 72-year-old man was referred to our institute with a chief complaint of left inguinal bulge. The bulge was observed in the left groin region in the standing position, and disappeared spontaneously in the supine position. Though an inguinal hernia was highly suspected, residual testicular swelling was atypical for the disease. An additional contrast-enhanced CT scan revealed pancreatic adenocarcinoma with retroperitoneal invasion, and para-aortic lymph node metastases. The tumor had invaded a left renal vein, causing a dilation of a left spermatic vein and the varicocele testis.The patient was diagnosed with advanced pancreatic cancer and received gemcitabine and nab-paclitaxel as a 1st line chemotherapy and irinotecan as a 2nd line treatment. The patient is now alive 12 months after diagnosis.There have been very few cases of pancreatic cancer detection due to suspected inguinal hernia. Among the cases, only two cases of varicocele testis from renal vein invasion of pancreatic cancer have been reported including this case. Here, we report a very rare case with a literature review.