停留精巣を伴った大腸癌精巣上体転移の1例

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  • A Case of Epididymal Metastasis with Cryptorchidism from Colon Cancer

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The patient is a 51-year-old man who underwent surgery for descending colon cancer in December 2007 (D, type 3, 40×50 mm, tub2, SE, N1, H0, P0, M0, Stage a, D2, PM0, DM0, RM0, R0, Cur A). He visited our hospital because a larger mass was found and he had pain in the left inguinal region since September 2008. We diagnosed left cryptorchidism and testicular tumor, and performed high orchiectomy. With histological assessment, we found high columnar tubular adenocarcinoma proliferating in the epididymal stroma. In addition, immunohistochemical tests revealed positive results for Cytokeratin 20, but negative results for Cytokeratin 7 and Calretinin. Considering the above, the tumor was diagnosed as metastasis from colon cancer. After the operation, bloody stool and constipation were recognized. Colon fiberscopy revealed tumors at the anastomosed colon and the rectum. We performed surgery again to resect these tumors. With histological assessment, we found another new metachronal cancer at the anastomosed colon, and it is assumed that its peritoneal dissemination caused the metastasis to the large bowel and epididymidis.

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