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结直肠癌患者的精索转移:一例病例报告及文献复习

Spermatic cord metastasis in patient with colorectal adenocarcinoma: A case report and review of literature.

作者信息

Rai Pranjal, Kumar Pradeep, Joseph Joe, Lakhani Dhairya A

机构信息

Tata Memorial Hospital, Department of Radiology, Mumbai, India.

Department of Neuroradiology, West Virginia University, Morgantown, WV, USA.

出版信息

Radiol Case Rep. 2025 May 24;20(8):4004-4007. doi: 10.1016/j.radcr.2025.04.116. eCollection 2025 Aug.

Abstract

We describe a rare instance of spermatic cord metastasis in a 30-year-old male with a history of colorectal adenocarcinoma. Despite undergoing left hemi-colectomy and adjuvant chemotherapy, the patient presented 5 years later with right groin pain and swelling, accompanied by rising carcinoembryonic antigen (CEA) levels. Imaging and histopathological examination confirmed metastatic adenocarcinoma. The patient underwent a right sided high inguinal orchidectomy for the same followed by a course of adjuvant chemotherapy. A year later, a second recurrence was identified close to the surgical scar site, following which he underwent re-surgery followed by adjuvant chemotherapy. This case underscores the importance of long-term surveillance in colorectal cancer patients, particularly those with lymphovascular invasion (LVI), and highlights the need to consider atypical metastatic sites in follow-up assessments. Additionally, atypical clinical symptoms should be assessed cautiously as they may preclude a more insidious etiology and require a thorough assessment by the oncologist.

摘要

我们描述了一例罕见的精索转移病例,患者为一名30岁男性,有结肠腺癌病史。尽管接受了左半结肠切除术和辅助化疗,但患者在5年后出现右腹股沟疼痛和肿胀,同时癌胚抗原(CEA)水平升高。影像学和组织病理学检查证实为转移性腺癌。患者随后接受了右侧高位腹股沟睾丸切除术,并进行了一个疗程的辅助化疗。一年后,在手术瘢痕部位附近发现了第二次复发,之后他接受了再次手术及辅助化疗。该病例强调了对结直肠癌患者进行长期监测的重要性,尤其是那些有淋巴管侵犯(LVI)的患者,并突出了在随访评估中考虑非典型转移部位的必要性。此外,对于非典型临床症状应谨慎评估,因为它们可能掩盖更隐匿的病因,需要肿瘤学家进行全面评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bec3/12151154/e20c1a7036e6/gr1.jpg

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