Verma Nidhi, Babu Suresh, Kushwaha Jitendra Kumar, Singhai Atin
Department of Pathology, KGMU, Lucknow, Uttar Pradesh, India.
BMJ Case Rep. 2013 Feb 25;2013:bcr2012007849. doi: 10.1136/bcr-2012-007849.
Metastasis of colorectal carcinoma to testis is rare. The authors report a case of 35-year-old man with right testicular mass. Contrast-enhanced CT scan (CECT) of testes showed testicular mass with ascitis and enlargement of retroperitoneal lymphnodes. Thus, a provisional diagnosis of disseminated primary testicular tumour was made. On subsequent high orchidectomy pathological examination revealed mucinous adenocarcinoma with CDX2 positivity thereby suggesting the possibility of metastasis from adenocarcinoma. Further, the diagnostic evaluation revealed a colorectal mass, which was inoperable (stage IV) and found to be primary colorectal mucinous adenocarcinoma. The authors conclude that occult colorectal carcinoma may rarely metastasise to testis and this unusual presentation may produce diagnostic dilemma. Although rare, metastases to testes should be considered as a differential diagnosis, especially where symptoms are unusual for primary malignancy.
结直肠癌转移至睾丸罕见。作者报告了一例35岁男性,其右侧睾丸有肿块。睾丸增强CT扫描(CECT)显示睾丸肿块伴有腹水及腹膜后淋巴结肿大。因此,初步诊断为播散性原发性睾丸肿瘤。随后的高位睾丸切除术后病理检查显示为黏液腺癌,CDX2呈阳性,提示可能为腺癌转移。此外,诊断评估发现一个无法手术切除(IV期)的结直肠肿块,病理检查为原发性结直肠黏液腺癌。作者得出结论,隐匿性结直肠癌极少转移至睾丸,这种不寻常的表现可能会造成诊断困境。虽然罕见,但转移至睾丸应被视为鉴别诊断之一,尤其是在症状不符合原发性恶性肿瘤的情况下。