An unusual testicular mass in a young male: Metastasis from occult gastric carcinoma

Metastases to the testis are uncommon. Signet-ring cell carcinomas from the gastrointestinal tract (GIT) can rarely disseminate to the testicles, mimicking primary testicular malignancies with signet-ring cells. We hereby describe a case of a 26-year-old male who presented with left testicular swelling, multiple lymphadenopathies, and normal serum tumor markers. Lymph node biopsy revealed clusters and singly lying signet-ring cells. Judicious use of immunohistochemistry confirmed the tumor to be GIT primary. Further investigations confirmed a gastric tumor extending to the duodenum. Although rare, metastatic tumors to the testis should be considered in differential diagnoses of testicular masses in a young patient, particularly when serum germ cell tumor markers are normal or mildly deranged.

CARCINOMA COLON SIGNET-RING CELL TYPE: A RARE CASE REPORT

Carcinoma colon ranks third among the commonest cancer in the world, while seen less common in the Asian countries however lately an increasing trend has been observed. Majorly the elderly population is at an increased risk of colon cancer however early onset of the disease has also been observed in past few years. Various histologic subtypes with different prognoses are present, but the most common histological type is Adenocarcinoma (1). Signet-ring cell carcinoma (SRCC) is a known rare subtype of colorectal carcinoma (< 1%) officially recognized by the WHO, mucinous types are aggressive with poor outcomes and are most commonly diagnosed around the fourth to fifth decade of life comprising only 1% of colorectal cancers. So we report a case of a 40-year-old male with adenocarcinoma colon of signet ring cell type. The patient presented with localized abdominal discomfort with only generalized weakness and fatigue which was later evaluated to be a near-obstructing right-sided colonic mass. Patient was taken up for surgery and was found to have diffuse carcinomatosis

Development and Validation of Prognostic Nomogram Based on Negative Lymph Node Count for Patients with Gastric Signet Ring Cell Carcinoma / 肿瘤防治研究

Objective To explore the influence of negative lymph node count (NLNC) on the prognosis of patients with gastric signet ring cell carcinoma (GSRC) and develop a prognostic nomogram based on NLNC. Methods On the basis of the SEER database, 2 101 patients diagnosed with GSRC were collected and randomly divided into the modeling group and validation group to test the relationship between clinicopathological characteristics and the prognosis of GSRC. The multivariate Cox proportional hazard regression model was used to analyze the independent risk factors affecting overall survival and establish a prognostic prediction model. The consistency index (C-index), calibration curve, net reclassification index (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA) were used to evaluate the accuracy and clinical applicability of the nomogram. Results All patients were divided according to the ratio of 7:3, with 1 473 in the modeling group and 628 in the validation group. NLNC > 10 (HR=0.578, 95%CI: 0.504-0.662, P < 0.001) was a protective factor for the prognosis of patients with GSRC, and the nomogram model was established based on multivariate Cox proportional hazards model. The C-index values of the nomogram were 0.737 (95%CI: 0.720-0.753) and 0.724 (95%CI: 0.699-0.749) in the modeling and validation groups, respectively, showing good discrimination. The calibration curves showed high consistency of the model. NRI=17.77%, continuous NRI=36.34%, and IDI=4.2% indicated that the model had positive returns compared with the traditional model. The DCA was far from the baseline, indicating that the model had good clinical applicability. Conclusion The increase in NLNC is a favorable factor for the prognosis of patients with GSRC, and a relatively accurate nomogram was established to predict the prognosis of patients with GSRC and help clinicians conduct individualized prognostic evaluations.

Effects of PD 98059 Combined with Paclitaxel on Cell Proliferation and Apoptosis of Human Gastric Signet Ring Cell Carcinoma Cells / 中国药房

OBJECTIVE：To investiga te the effects of MEK/ERK pathway specific inhibitor PD 98059 combined with paclitaxel on the proliferation and apoptosis of human gastric signet ring cell carcinoma （SRCC）cells. METHODS ：Using human SRCC KATO Ⅲ cells as object ，CCK-8 assay was used to detect cell proliferation after treated with paclitaxel ，PD98059 and two drug combination for 48 h，and the proliferation rate was calculated. Flow cytometry ，Western blotting and Transwell assay were used to detect the cell proliferation ，the expression of apoptosis related protein （Cleaved-caspase-3）and cell migration after treated with paclitaxel，PD98059 and two drug combination for 48 or 24 h. RESULTS ：After treated with paclitaxel （1 μg/mL），PD98059（5， 20，40 μmol/L）and two drug combination （1 μg/mL+5，20，40 μmol/L），the proliferation rate of cells was increased significantly in administration groups ，and the combination groups were significantly higher than paclitaxel and PD 98059 alone groups （P＜ 0.05）. After treated with paclitaxel （1 μg/mL），PD98059（5，20，40 μmol/L）and two drug combination （1 μg/mL+40 μmol/L）， early and late apoptosis rate ，the protein expression of Cleaved-caspase- 3 were significantly increased in paclitaxel group and combination group ；combination group was significantly higher than paclitaxel and PD 98059 alone group （P＜0.05）. The number of migrated cells in administration groups were reduced significantly ，and the combination group was significantly lower than paclitaxel and PD 98059 alone group （P＜0.05）. CONCLUSIONS ：Paclitaxel and PD 98059 can inhibit the proliferation and migration of human SRCC KATO Ⅲ cells，paclitaxel can also promote the apoptosis and the expression of apoptosis related protein，which may be related to the inhibition of MEK/ERK pathway. The effect of the combination of the two drugs is better than paclitaxel or PD 98059 alone.

Clinicopathological Correlation Of Gastric Endoscopic Biopsies In A Tertiary Care Hospital In Rural Area In Haryana

The study included gastric endoscopic biopsies received in the department of pathology, MMIMSR,Mullana, Haryana. 130 gastric biopsies were included in the study. The most common presentingcomplaint was pain abdomen. The neoplastic lesions commonly presented as carcinoma whereas thenon-neoplastic lesions presented as inflammatory lesions on endoscopy. Non-neoplastic lesions werefound to be common out of which gastritis was the most common lesion. Associated conditions werefound to be H. Pylori and intestinal metaplasia with gastritis. Majority of the lesions were nonneoplastic, presenting with pain abdomen & inflammatory findings on endoscopy. The neoplasticlesions comprised of adenocarcinoma & signet ring cell carcinoma. 4 cases of signet ring cell carcinomawere noted. Percentage of concordance between endoscopic & histologic diagnoses was calculatedwherein cases of gastritis, ulcer, polyps & carcinoma showed 100%, 96.3%, 71.4% & 100%concordance respectively.The conclusion of the study was that histological examination in adjunct with endoscopy should beconsidered as much more valuable diagnostic tool rather than endoscopy alone.

Postoperative Radiotherapy Improves Survival in Gastric Signet-Ring Cell Carcinoma: a SEER Database Analysis

PURPOSE: To identify the potential therapeutic role of postoperative radiotherapy (RT) in patients with locally advanced (stage II and stage III) gastric signet ring cell carcinoma (SRC).MATERIALS AND METHODS: Patients with locally advanced gastric SRC from the Surveillance, Epidemiology, and End Results program database between 2004 and 2012 were included in our study. Univariate and multivariate Cox proportional models were performed, and survival curves were generated to evaluate the prognostic effect of postoperative RT and surgery alone on SRC patients. Propensity score matching (PSM) was used to avoid selection bias among the study cohorts.RESULTS: We found that patients with postoperative RT had better probability of survival compared with those who did not receive RT (overall survival [OS], P<0.001; cancer-specific survival [CSS], P<0.001). After PSM, analysis of both overall and CSS showed that patients who underwent postoperative RT had better prognosis than those receiving surgery alone in the matched cohort (OS, P=0.00079; CSS, P=0.0036). Multivariate Cox proportional model indicated that postoperative RT had better effect on prognosis compared with surgery alone with respect to both overall (hazard ratio [HR], 0.716; 95% confidence interval [95% CI], 0.590–0.87; P=0.001) and CSS (HR, 0.713; 95% CI, 0.570–0.890; P=0.003).CONCLUSIONS: Postoperative RT had better prognosis compared with surgery alone for both overall and CSS for patients with locally advanced gastric SRC.

La presencia de células en anillo de sello en la biopsia endoscópica no es un buen predictor para el diagnóstico de carcinoma gástrico de células en anillo de sello / The presence of signet-ring cell in endoscopic biopsy is not a good predictor for the diagnosis of signet-ring cell carcinoma of the stomach

Resumen Introducción El carcinoma gástrico de células en anillo de sello (CGCAS) es un tipo histopatológico, que tiene menor respuesta a la quimioterapia (QT) y un peor pronóstico en los pacientes con cáncer gástrico (CG) avanzado. Se desconoce los valores diagnósticos de la presencia de células en anillo de sello (CAS) en la biopsia endoscópica, para el diagnóstico de CGCAS. Objetivo Determinar los valores diagnósticos de la presencia de CAS en la biopsia endoscópica para el diagnóstico de CGCAS en la biopsia de la pieza operatoria. Material y Método Estudio retrospectivo de pruebas diagnósticas. Se incluyeron los pacientes con CG operados en forma consecutiva entre 1996-2016. Se calculó los valores diagnósticos de la presencia de CAS en la biopsia endoscópica para el diagnóstico de CGCAS en la biopsia definitiva. Se utilizaron intervalos de confianza (IC) del 95%. Resultados Se incluyeron 851 pacientes. Un 16,3% tuvieron CAS en la biopsia endoscópica y la prevalencia de CGCAS fue de 16,4%. Los valores diagnósticos de la presencia de CAS de la biopsia endoscópica para el diagnóstico de CGCAS fueron: Valor predictivo positivo (VPP) de 56,1% (IC 95%, 47,8-64,1%); Valor predictivo negativo (VPN) de 91,3% (IC 95%, 89-93,1%); sensibilidad de 55,7% (IC 95%, 47,4-63,7%); especificidad de 91,4% (IC 95%, 89,1%-93,3%); Likelihood ratio (LR) positivo de 6,5 (IC 95%, 4,9-8,6); LR negativo de 0,48 (IC 95%, 0,4-0,6); probabilidad post-test positivo fue de 56,1% (IC 95%, 47,8-64,1%) y probabilidad post-test negativo fue de 8,7% (IC 95%, 6,9-11%). Conclusiones La presencia de CAS en la biopsia endoscópica es insuficiente para el diagnóstico de un CGCAS. La ausencia de CAS en la biopsia endoscópica tiene un alto valor predictivo negativo.

Introduction Signet-ring cell carcinoma (SRCC) of the stomach is a histopathological type that has less response to chemotherapy and worse prognosis in patients with advanced gastric cancer, than other types of gastric carcinomas. Diagnostic value of the presence of signet-ring cells (SRC) in the endoscopic biopsy for the diagnosis of SRCC of the stomach, are unknown. Objectives To calculate the diagnostic values of the presence of SRC in endoscopic biopsy for the diagnosis of SRCC of the stomach in a definitive surgical specimen biopsy. Materials and Methods Retrospective diagnostic test study to determine the value of the presence of SRC in the endoscopic biopsy for the diagnosis of SRCC of the stomach in the surgical specimen biopsy. Inclusion criteria: Patients who underwent gastric surgery between 1996-2016. We calculated positive and negative predictive values (PPV and NPV), sensitivity, specificity, and positive and negative likelihood ratio (LR+ and LR−) of the presence of SRC in the endoscopic biopsy that predicts the diagnosis of SRCC of the stomach in the definitive biopsy. Confidence intervals (CI) of 95% were defined. Results The diagnostic values of the presence of SRC in endoscopic biopsy to diagnose SRCC of the stomach in the surgical specimen biopsy were: PPV of 56.1% (95% CI, 47.8-64.1%), NPV of 91.3% (95% CI, 89-93.1%), sensitivity of 55.7% (95% CI, 47.4-63.7%), specificity of 91.4% (95% CI, 89.1-93.3%), LR+ of 6.5 (95% CI, 4.9-8.6) and LR- of 0.48 (95% CI, 0.4-0.6), a positive post-test probability of 56.1% (95% CI, 47.8-64.1%), and a negative post-test probability of 8.7% (95% CI, 6.9-11%). Conclusions The presence of SRC in the endoscopic biopsy is not sufficient to diagnose SRCC of the stomach. The absence of SRC in the endoscopic biopsy has a high negative predictive value.

Primary Signet Ring Cell Carcinoma of the Gallbladder Mimicking Calculous Cholecystitis / 대한췌담도학회지

Signet ring cell carcinoma is a rare form of gallbladder cancer and has a worse prognosis. Since few cases have been reported, information regarding the behavior and prognosis of the gallbladder carcinoma is limited. About twenty four cases of gallbladder signet ring cell carcinoma have been reported so far. We present a rare case of primary signet ring cell carcinoma of the gallbladder. A 58-year-old male presented with epigastric pain. Abdominal computed tomography showed diffuse gallbladder wall thickening with enhancement, gallstones, and choledocholithiasis. After endoscopic treatment of choledocholithiasis, laparoscopic cholecystectomy was performed. Pathologic examination of the resected gallbladder revealed adenocarcinoma of signet ring cell type in the epithelium. Immunohistochemical stain for cytokeratin 7 was positive for tumor cells. The final pathologic diagnosis was primary signet ring cell carcinoma of the gallbladder. Lymph node metastasis was detected and he received chemotherapy and radiotherapy. After one year of follow-up, bone metastasis in the lumbar spine and malignant ascites were found. The patient is being provided with palliative care.

Clinicopathological characteristics and prognosis analysis of Uygurs and Hans signet ring cell carcinoma of Xinjiang / 实用医学杂志

Objective To analyze the differences in the clinical characteristics,pathological characteristics and survival between Uygurs and Hans gastric signet ring cell carcinoma (SRC) ,and the clinicopathological data of Uygurs SRC were analyzed by COX proportional hazard model. Methods 120 clinical data of patients with gastric cancer from January 2009 to January 2015 were analyzed. The patients were divided into Uygurs and Hans gastric signet ring cell carcinoma (SRC). The gender,age,tumor location,size,depth of invasion,lymph node and distant metastasis,the median time to progression,survival rate after radical operation of two groups were analyzed. The clinicopathological data of 57 cases with Uygurs SRC were analyzed ,multivariate analysis was done by COX proportional hazard model. Results In Uygurs,the age,lymphnode metastasis,distant metastasis and the median time to progression were statistically different from Hans (P 0.05). Conclusion Compared with Uygurs,Hans has early age of onset,more lymph node and distant metastasis,and is prone to progression. Also,age,lymphnode metastasis and depth of invasion serve as independently prognostic indexes of Uygurs gastric SRC by COX proportional hazard model.

Significance of K-ras gene status and ras protein expression in immunophenotypic classification of gastric signet ring cell carcinoma / 重庆医学

Objective To investigate the significance of K-ras gene status and ras protein expression in immunophenotypic classification of gastric signet ring cell carcinoma.Methods The expression of ras protein in 180 cases of gastric signet-ring cell carcinoma was detected by tissue microarray immunohistochemistry.Meanwhile,the mutation in codon 12,13 of K-ras gene was determined by using PCR-based DNA direct sequencing analysis.Results The rate of ras protein expression was 27.8％.The rate of ras protein expression in intestinal phenotype was significantly higher than those in gastric and gastrointestinal phenotypes(P<0.05).The rate of ras protein expression in cases with lymph node metastasis was significantly higher than those in cases without nodal involvement(P<0.05).The rate of ras protein expression was significantly higher in cases with deeper invasion(P<0.05).The frequency of K-ras gene mutation was 22(12.2％).All of them were found in codon 12.The types of mutation included GGT→AGT(1 case),GGT→TGT(1 case),GGT→GCT(2 cases),GGT→GTT(8 cases)and GGT→GAT(10 cases).K-ras mutation was significantly associated with intestinal phenotype(P<0.05).The rates of ras protein expression in cases with mutational type of K-ras gene was higher than those in cases with wild type(P<0.05).The ras protein expression was positively associated with K-ras gene mutation(r=0.61,P<0.05).Conclusion The ras protein expression is correlated with nodal involvement and invasion.K-ras gene mutation and expression of ras protein is related to phenotypic classification,and they might influence the phenotypic transformation in gastric signet ring cell carcinoma.

The clinicopathologic factors analysis of early mixed signet ring cell in gastric carcinoma / 实用肿瘤学杂志

Objective To analyze the clinic pathologic factors and survival rate by performing a retro-spective study on the early gastric carcinoma (EGC)with signet ring cell underwent curative gastrostomy (SRC) percentage less than 50%after operation .Methods A total of 424 patients was diagnosed as EGC from January 2008 to January 2010 in Changhai Hospital .The patients were divided into three groups according to the different percentage of SRC within tumor cells , SRC group ( with percentage of SCR more than 50%) , Mixed SRC group (with percentage of SRC less than 50%),and Non-SRC group(Classic adenocarcinoma without SRC ).Then we evaluated the clinic pathologic indicators and prognoses , and study on the relationship with histologic types . Results In ECG,the mixed-SRC group was similar to the SRC group on the phases of onset age and sex .On the other phases,the mixed-SRC group was more associated with mucosa -confined,lower lymph node metasta-sis(LNM),and 5-year survival rate was better than adenocarcinoma group (P<0.05).However,the mixed-SRC group showed more submucosal invasion ,and higher LNM than other groups ( P<0 .05 ) .The mixed-SRC component was one of the independent risk factors of LNM .Conclusion In EGC,mixed-SRC had a more favor-able risk factor of LNM ,showed more aggressive behavior than other groups and displayed poor prognosis .

A Case of Advanced Gastric Cancer Presenting as Multiple Colonic Lymphoid Hyperplasia / 대한소화기학회지

Gastric cancer frequently disseminates to the liver, lung, and bone via hematogeneous, lymphatic, or peritoneal routes. However, gastric adenocarcinoma that metastasize to the colon and that shows typical linea platisca pattern on colonofiberscopy has rarely been reported. Recently, the authors experience a case of advanced gastric cancer with colonic metastases in a 55-year-old female patient. Multiple colonic lymphoid hyperplasias were detected on colonofiberscopy and biopsy revealed metastatic gastric cancer to the colonic wall. She was treated with mFOLFOX (5-FU, oxaliplatin, leucovorin) and has achieved stable disease status without disease progression. Herein, we report a rare case of signet ring-cell gastric cancer which metastasized to the colon in the form of multiple colonic lymphoid hyperplasias.

Pleural Metastasis as Initial Presentation of Occult Gastric Cardia Cancer: A Possible Role of PET-CT in Diagnosis / Journal of the Korean Cancer Association, 대한암학회지

We report on a case of malignant pleural effusion as initial metastatic presentation of occult gastric cardia cancer in a young woman. To the best of our knowledge, this is the first report of gastric adenocarcinoma metastasized to pleura as an initial presentation. Location of cardia and signet ring cell histology may contribute to the manifestation. Utilization of positron emission tomography-computed tomography was helpful for proper diagnosis. For patients with such distinct clinical presentations, it would be appropriate to consider gastric cancer as one of the possible primary sites.

A Case of Pericolonic Metastasis in Recurrent Signet-Ring-Cell Adenocarcinoma Diagnosed by Endoscopic Ultrasound-Guided Fine-Needle Aspiration Using a Forward-Viewing Echoendoscope / 대한내과학회지

Endoscopic ultrasound-guided fine-needle aspiration is used for the diagnosis and evaluation of rectal and pelvic lesions in lower gastrointestinal tract disease. However, it is not used widely in proximal and transverse colon disease because of the limited visual field and technical problems related to an oblique-viewing echoendoscope. Here, we report a case of recurrent signet-ring-cell gastric adenocarcinoma involving the transverse colon not diagnosed by repeated colonoscopic biopsies that was eventually diagnosed using a forward-viewing echoendoscope with fine-needle aspiration biopsy.

A Case of Pericolonic Metastasis in Recurrent Signet-Ring-Cell Adenocarcinoma Diagnosed by Endoscopic Ultrasound-Guided Fine-Needle Aspiration Using a Forward-Viewing Echoendoscope / 대한내과학회지

Endoscopic ultrasound-guided fine-needle aspiration is used for the diagnosis and evaluation of rectal and pelvic lesions in lower gastrointestinal tract disease. However, it is not used widely in proximal and transverse colon disease because of the limited visual field and technical problems related to an oblique-viewing echoendoscope. Here, we report a case of recurrent signet-ring-cell gastric adenocarcinoma involving the transverse colon not diagnosed by repeated colonoscopic biopsies that was eventually diagnosed using a forward-viewing echoendoscope with fine-needle aspiration biopsy.

A Case of Primary Signet Ring Cell Carcinoma of the Lower Eyelid

PURPOSE: To report a rare case of a painless mass on the lower lid, histologically diagnosed as primary signet ring cell carcinoma of the eyelid. CASE SUMMARY: A 74-year-old male presented with a painless mass on the right lower lid which had developed seven months prior to presentation. Incisional biopsy of the mass and attached lower lid skin was performed, revealing signet ring cell carcinoma. A systemic evaluation, including whole body positron emission tomography-computed tomography (PET-CT), chest CT, abdomen and pelvis CT, gastrointestinal endoscopy, and colonoscopy, revealed no other abnormal lesions. Therefore, the eyelid lesion was considered primary signet ring cell carcinoma of the skin and was treated with radiotherapy of 6600 cGy in 33 fractions over 7 weeks. CONCLUSIONS: Herein, the authors report a rare case of primary signet ring cell carcinoma of the eyelid with no evidence of tumor recurrence or metastasis for 5 years after radiotherapy.

Leptomeningeal Carcinomatosis of Gastric Cancer Misdiagnosed as Vestibular Schwannoma

Gastric cancer is one of the most common causes of cancer-related death in Asian countries, including Korea. We experienced a case of leptomeningeal carcinomatosis (LC) from gastric cancer that was originally misdiagnosed as vestibular schwannoma based on the similar radiological characteristics. To our knowledge, LC from gastric cancer is very rare. In conclusion, our experience with this case suggests that clinicians should consider the possibility of delayed leptomeningeal metastasis when treating patients with gastric cancer.

A Case of Gastric Signet Ring Cell Carcinoma in Young Adult with Nodular Gastritis; On Follow-up without Helicobacter pylori Eradication

A 29-year-old man with nodular gastritis diagnosed by previous gastroscopy was referred to our hospital for an evaluation of laryngeal discomport and soreness. The patient had no previous history of eradication for Helicobacter pylori-associated gastritis. Gastroscopy demonstrated the presence of gooseflesh-like nodularities on antrum and whitish discoloring lesion with depression on lesser curvature of lower body. The whitish discoloring lesion with depression was histologically diagnosed a signet ring cell carcinoma by endoscopic biopsy. We report this case of a patient with nodular gastritis who received no eradication therapy and was diagnosed with signet ring cell carcinoma with a review of the literature.

A Case of Gastric Signet Ring Cell Carcinoma in Young Adult with Nodular Gastritis; On Follow-up without Helicobacter pylori Eradication

A 29-year-old man with nodular gastritis diagnosed by previous gastroscopy was referred to our hospital for an evaluation of laryngeal discomport and soreness. The patient had no previous history of eradication for Helicobacter pylori-associated gastritis. Gastroscopy demonstrated the presence of gooseflesh-like nodularities on antrum and whitish discoloring lesion with depression on lesser curvature of lower body. The whitish discoloring lesion with depression was histologically diagnosed a signet ring cell carcinoma by endoscopic biopsy. We report this case of a patient with nodular gastritis who received no eradication therapy and was diagnosed with signet ring cell carcinoma with a review of the literature.

Metastatic tumour of spermatic cords, epididymis and seminiferous duct from gastric carcinoma / Tumor metastásico de los cordones espermáticos, el epidídimo y el conducto seminífero a partir de un carcinoma gástrico

Metastatic tumour of spermatic cords, epididymis and seminiferous duct from gastric carcinoma has been recently reported but rarely seen. A case of metastatic tumour from gastric carcinoma in a 50-year old man is herein reported. The initial diagnosis was thickening of both spermatic cords. Needle biopsy of the spermatic cord, testicle and epididymis was performed. Pathological findings showed a gastric signet ring cell carcinoma. Thus, double radical orchiectomy was performed and metastatic signet ring cell carcinoma of the spermatic cord and testis was diagnosed through histological examination and immunohistochemistry. Physicians should be aware that gastric carcinoma is one of the possibilities for metastasis to the seminal duct.

El tumor metastásico de los cordones espermáticos, el epidídimo y el conducto seminífero a partir de un carcinoma gástrico ha sido reportado recientemente, pero pocas veces visto. En este trabajo se reporta el caso de un tumor metastásico a partir de un carcinoma gástrico en un hombre de 50 año de edad. El diagnóstico inicial fue el engrosamiento de los dos cordones espermáticos. Se realizó una biopsia con aguja del cordón espermático, testículos y epidídimo. Los resultados patológicos mostraron un carcinoma de células en anillo de sello. Por consiguiente, se realizó una orquiectomía radical doble, y el carcinoma metastásico en anillo de sello del cordón espermático y el testículo, fue diagnosticado mediante examen histológico e inmunohistoquímico. Los médicos deben tener presente que el carcinoma gástrico es una de las posibilidades de metástasis en los conductos seminales.