• abdominal aortic aneurysm
• duodenum
• obstructive jaundice

• Humans
• Aged
• Duodenal Obstruction/diagnostic imaging
• Duodenal Obstruction/etiology
• Jaundice, Obstructive/etiology
• Jaundice, Obstructive/complications
• Aortic Aneurysm, Abdominal/complications
• Aortic Aneurysm, Abdominal/diagnostic imaging
• Syndrome

Metastases from pancreas or ampullary malignancies are common, but the spread to testicle and paratesticular tissue is exceedingly rare. To the best of our knowledge, fewer than 30 cases have been reported in the literature. More rarely, metastasis to tunica vaginalis testis occurs without involvement of the testes and epididymis.

A 65-year-old male who complained of painless swelling of the left scrotum for over 1 wk was referred to the Department of Urology. Scrotal ultrasound showed left testicular hydrocele with paratesticular masses. Chest computed tomography revealed lung metastasis and enlarged left supraclavicular lymph node.The blood tumor markersalpha-fetoprotein, human chorionic gonadotropin, and serum lactate dehydrogenase were withinnormal limits.The preoperative diagnosis was left testicular tumor with lung metastasis. Then radical orchidectomy of the left testicle and high ligation of the spermatic cord were performed, and postoperative histopathology suggested metastatic tumors that was confirmed by an abdominal computed tomographic scan. The positive computed tomography findings, in conjunction with the expression of cytokeratin 7 (CK7), CK20, CK5/6, and absence of expression of Wilms’ tumor suppressor gene 1, calretinin, melanocyte, prostate-specific antigen, thyroid transcription factor-1, GATA binding protein 3, caudal type homeobox 2, and napsinA supported the diagnosis of pancreatic adenocarcinoma. The outcome of this patient was unsatisfactory, and he died 3 mo later.

This case suggests that pancreatic metastatic carcinoma must be considered in the differential diagnosis of scrotal enlargement. The advanced age of the patient wassuggestive of a secondary testicular tumor.In addition, careful physical examination and ultrasonography as well as radiological examination have become a standard modality.

• Tunica vaginalis testis
• Metastasis
• Pancreatic adenocarcinoma
• Literature review
• Paratesticular tumor
• Misdiagnosis
• Case report

Invasive lobular carcinoma is the second most common type of invasive carcinoma of the breast. Although rare, invasive lobular carcinoma can lead to gastric metastases, which may appear several years after the initial diagnosis. The diagnosis is difficult, either because of its rarity or because of overlapping symptoms and imaging findings with primary gastric carcinoma. Immunohistochemistry is the key to diagnosis. We report a case of a 40-year-old woman with a previous history of invasive lobular carcinoma of the breast 2 years before, who presented recurrent and nonspecific gastrointestinal symptoms. Imaging findings revealed linitis plastica and the biopsy showed the presence of signet ring cell neoplasia. After gastrectomy, immunohistochemistry demonstrated diffuse expression of GATA-3 and the presence of estrogen receptors in some neoplastic cells with CK20^-, leading to the final diagnosis of gastric metastases from invasive lobular carcinoma of the breast.

• Gastric metastases
• Immunohistochemistry
• Linitis plastica
• Lobular breast cancer

• Gastrointestinal bleeding
• Hemosuccus pancreaticus
• Hemosuccus pancreatitis
• Pancreas
• Pancreatitis
• Pseudoaneurysm

• Aneurysm, False/therapy
• Embolization, Therapeutic
• Endovascular Procedures
• Gastrointestinal Hemorrhage/etiology
• Humans
• Pancreatic Ducts
• Pancreatitis/complications
• Splenic Artery
• Tomography, X-Ray Computed

• GI bleeding
• chemotherapy
• end of life decisions (palliative care)
• gynecological cancer
• stomach and duodenum