Hepatocellular carcinoma metastatic to the testis.

A 57-year-old man had upper gastrointestinal signs and symptoms associated with testicular swelling and elevation of the serum alpha-fetoprotein level. Abdominal exploration revealed a large solitary liver mass and massively enlarged retroperitoneal lymph nodes, and a right scrotal exploration revealed a 4-cm testicular tumor. An orchidectomy and retroperitoneal biopsy were performed. The tumor was composed of nests, sheets, trabeculae, and clusters of polyhedral cells with eosinophilic cytoplasm and nuclei with prominent nucleoli. The tumor cells stained strongly for alpha-fetoprotein, alpha 1-anti-trypsin, and albumin by the immunoperoxidase technic. The clinical, light microscopic, and immunocytochemical features indicate that the testicular tumor was a metastatic hepatocellular carcinoma, only the second reported case of this type.