Klatskin tumor with spermatic cord metastasis: a case report.

Malignant spermatic cord tumor is quite uncommon. Metastatic spermatic cord tumor is even rarer. Here we report a case of metastatic spermatic cord tumor from a common hepatic duct tumor (Klatskin tumor). A 38-year-old man presented with right scrotal enlargement and chronic testicular pain. He had a Klatskin tumor (cholangiocarcinoma) stage IIIa, and underwent an extended right hepatectomy with resection of the extrahepatic bile duct, and portal vein and reconstruction by Roux-en-y hepatico-jejunostomy one year before this presentation. Scrotal ultrasound revealed a moderate hydrocele with clean content. Scrotal exploration showed turbid fluid and a fibrotic hyperemic spermatic cord. Excision biopsy of the spermatic cord was done, and the pathology revealed adenocarcinoma. The primary cholangiocarcinoma tumor and the spermatic cord tumor showed identical histologic patterns. Klatskin tumor with spermatic cord metastasis was diagnosed. To our knowledge, this case represents the first such report in the literature.