Abstract

Renal cell carcinoma is notorious for its wide metastasis to the nearly all systemic organs, frequently to the lung, lymph nodes, liver and bone and rarely to the tesis, epididymis, and ovary via testicular or ovarian veins. Herein reported is rare metastatic renal cell carcinoma in the epididymis and spermatic veins showing quite similar histology to the papillary cystadenoma of primary origin. The patients was a 73 years old male admitted to the KAERI Hospital on Jan. 9th. 1980 with chief complaints of gross hematuria. CBC and chest X-ray findings were within normal limits. Urinalysis revealed only hematuria. Right kidney was not visuslized in IVP although left kidney showed normal appearance. Cystoscopic findings revealed hematuria from the right side ureter. Enlargement of para-aortic lymph nodes were noted during total nephrectomy of right side. Extirpated right kidney measured 16×8×7.5㎝. Cut surface exhibited yellowish and necrotic tumor mass in the upper pole, measuring 10×8㎝. The patients was irradiated by Co60 about 5,400 Rad after operation. Six months later right spermatic cord and epididymis was indurated but no other metastatic signs were noted. So resection of spermatic cord and epidymis was done under the impression of tuberculosis on Feb. 20th. 1981. cut surface exhibited yellowish white lobular appearance in both epididymis and surrounding spermatic veins but testis was remained intact. Microscopic findings revealed the same histologic features of the previous renal cell carcinoma of the kidney and many tumor emboli in the spermatic veins.