The "Krukrnberg" tumor in male.
OBJECTIVE
The ovarian metastasis by a gastrointestinal cancer is called Krukenberg tumor. We report a case of metastasis to the testis and epididymis by gastric cancer that can be the analogue in male.


METHODS
A patient, submitted to total gastrectomy for a poorly differentiated gastric adenocarcinoma (TNM stage: pT3 GIII N+ M 1) developed one year later a painful swelling of the right hemiscrotum and groin. The palpation revealed a painful mandarine-like mass conglobated in the right testis and epididymis, with a further mass at the external inguinal-ring and multiple little nodes along the spermatic cord. An inguinal orchifuniculectomy was performed and the histological tests described a poorly differentiated, microtubular adenocarcinoma, infiltrating the connective tissue, without spreading to the testis, that was properly structured. The atypical tumor formations expressed carcinoembryonal antigen, but were negative for -HCG and PSA. The immune-histochemical results confirmed the diagnosis of an adenocarcinoma.


CONCLUSIONS
The metastasis in testicles and/or epididymus are rare and cannot be differentiated clinically or by imaging procedures from a primary testicle neoplasia. Only the exact anamnesis of previous tumors and the age can provide some indications. The therapy of choice is however represented by inguinal orchifuniculectomy.
Alois
Mahlknecht
M
Urology Dept., Tappeiner Hospital, Meran, Italy.
Valentina
Pecorari
P
Andreas
Gschwendeter
G
D000230:Adenocarcinoma / Q000556:secondary*; D000368:Aged; D004822:Epididymis; D005834:Genital Neoplasms, Male / Q000556:secondary*; D006801:Humans; D008297:Male; D013274:Stomach Neoplasms / Q000473:pathology*; D013736:Testicular Neoplasms / Q000556:secondary*