Can pancreatic cancer metastasize to spermatic cord and testes? BMJ

UNITED STATES: Less than 20 cases present in scientific literature prove that the metastasis of pancreatic cancer to the male gonad is very rare. However, a recent case present shows proof of a similar metastatic trend.

A male patient aged 50 entered the outpatient department with an enlarged scrotum (right side). The patient has a history of smoking, hypertension and Type 2 Diabetes Mellitus. The enlargement has progressed aggressively and therefore scrotal sonography was done, which revealed a hydrocele on the right side without testicular lesions. A pancreatic tail lesion with the invasion of the spleen and left adrenal gland was identified through abdominal CT and MRI. 

The resected right testis and epididymis were normal in appearance, but the spermatic cord was hardened. 

Fine needle biopsy showed adenocarcinoma of the pancreatic tail with hematogenous metastasis to the right testis, epididymis, and spermatic cord. The medical team consulted with the oncology team to devise the treatment plan for this case. Radiation Chemotherapy was mutually agreed upon, and the patient underwent the treatment for several months.

However, Disease progression occurred despite the patient receiving palliative chemoradiation therapy. Further studies are required to understand such rare cases, in order to slow disease progression and metastasis.