A 61-year-old man was admitted to our hospital with a 8-day history of dull pain and swelling in the bilateral scrotum and bilateral inguinal region. Neoplasma of the spermatic cord was suspected, and bilateral orchiectomy was immediately carried out. Histopathological examination revealed thromboangiitis obliterans of the spermatic cord. The differential diagnosis of a tumorous lesion in the inguinal region is frequently difficult. In such a case, surgical exploration is recommended, and a biopsy must be performed for a definitive diagnosis, but orchiectomy should not be readily selected. Our patient is the first reported case in Japan to our knowledge.