Unilateral right-sided varicocele associated with pancreatic cancer: A cadaveric case report

A testicular varicocele is an abnormal dilation of the pampiniform plexus of veins within the spermatic cord. Due to the asymmetrical drainage pattern of the right and left testicular veins, the vast majority of varicoceles are found on the left side. Isolated right testicular varicoceles occur rarely and should raise clinical suspicion for underlying intra-abdominal pathology. During the dissection of a 67-year-old male cadaver a unilateral varicocele was discovered in the right spermatic cord. Upon dissection of the abdomen, a tumor was found in the head and body of the pancreas. The section of the inferior vena cava where the right testicular vein inserted laid directly posterior to the tumor and was markedly dilated. We hypothesize that this pancreatic tumor impeded venous return into the inferior vena cava from the right testicular vein and not the left renal vein (where the left testicular vein drains) resulting in a unilateral right varicocele (URV). To our knowledge, the relationship between URV and pancreatic cancer has not been previously described in the literature. Our findings suggest URV could be a clinical warning sign of cancer of the head and/or body of the pancreas and may be a source of discomfort to address in patients with pancreatic cancer in order to improve quality of life.