A 47yo man comes to the GP with a swelling in his left groin which disappears on lying down.
The swelling was bluish in color and felt like a bag of worms. He also complains of a mass in the
left loin along with hematuria occasionally. What could be the possible dx?
a. Left sided RCC
b. Varicosity 2nd to liver disease
c. Testicular tumor
d. UTI
e. IVC obstruction
Q. 1. What is the key?
Q. 2. What is the condition described?
Q. 3. What is the link between these two conditions?
Ans. 1. The key is A. Left sided Renal cell carcinoma.
Ans. 2. Left sided varicocele.
Ans. 3. Most common secondary cause of left sided varicocele is RCC. Newly diagnosed varicocele over the age of 40yrs are very much suggestive of RCC. Varicocele is common on left side as left testicular veins drain to the left renal vein, while the right testicular vein drain directly into IVC.