Spermatic cord metastasis of esophageal cancer, mimicking as an incarcerated hernia

Metastatic cancers in the spermatic cord are extremely rare. A 79-year-old man, who had undergone palliative chemotherapy and radiotherapy one year previously, due to inoperable esophageal cancer, visited our hospital suffering from right inguinal swelling. Ultrasonography showed echogenic lesions superior to the right testis, suspicious of a swollen bowel loop. An emergency exploration revealed no bowel content or mesentery, but with thickened of the spermatic cord and epididymis four times that of the contralateral side. Pathology confirmed a metastatic carcinoma, likely to have originated from the esophagus.