目的：報告一例罕見以漸進式右側陰囊靜脈曲張表現的右腎細胞癌病例。病例報告：一位41歲男性因右側陰囊皮下無痛性血管擴張而就診。理學檢查發現右側陰囊靜脈曲張及陰囊內精索靜脈曲張◦超音波檢查及腹部電腦斷層攝影顯示右腎有一個9.3公分的腫瘤並侵犯到右腎靜脈，右側睪丸靜脈因接受右腎的側枝循環而極度擴張並導致陰囊靜脈的擴張。他隨後接受右腎切除術，術後病理報告為右腎腎細胞癌合併腎靜脈腫瘤栓塞。病患的血管定便於術後一個月逐漸消失。術後兩年的追蹤中並無發現腫瘤復發。結論及重要性：成人右側的精索靜脈曲張常和某些疾病有關。本病歷報告提醒我們對於有心形成的右側陰囊靜脈曲張及陰囊內精索靜脈曲張之病患應做更一步的檢查。

Purpose: To present an uncommon clinical presentation of renal cell carcinoma (RCC) with progressive right scrotal wall varicose. Case report: A 41-year-old male patient visited our hospital due to progressive painless vessel engorgement beneath his right scrotal skin for 2 months. Physical examination revealed right scrotal wall varicose accompanied with right varicocele in his right scrotum. Ultrasound study and abdominal computerized tomography demonstrated a 9.3 cm heterogeneous tumor at the right kidney and extends into the renal vein. Dilation of the right gonadal vein was also noted owing to the receiving of collateral venous drainage from the right kidney which leaded to venous stasis in the right scrotum. He subsequently underwent a right radical nephrectomy, and the histopathological examination demonstrated RCC with renal vein thrombosis. His scrotal varicose veins and varicocele disappeared gradually in one month after operation. He has no tumor or vascular lesion recurrence in 2 years follow up. Conclusion and Importance: Adult right varicoceles usually link to some pathologic processes. This case report reminds further investigations are mandatory in patients with newly unset of right site scrotal wall varicose or varicocele.