A 24-year-old patient with a twin brother who underwent surgery in December 2005 for a combined neoplasm (adeno mucinous neoplasm and involvement of isolated goblet cells, T4N2M1) with multiple peritoneal implants, located in the wall
He underwent right hemicolectomy, peritonitis and resection of macroscopic implants of visceral peritoneum.
Subsequently, adjuvant chemotherapy was initiated with the mFOLFOX4 scheme for 12 cycles, with episodes of diarrhea after the second and third cycle and the stoicariform reaction after the seventh.
At the beginning of chemotherapy, the 24-hour urine 5HIAA was within normal parameters and the body scan with In.111 pentreotide and SPECT showed no abnormalities.
Ten months after surgery she had acute testicular pain.
On physical examination, the patient presented right-handed, enlarged, hard and irregular consistency test in the upper pole, as well as thickening of the string was persistent.
On testicular Doppler ultrasound, the right testicle showed increased caliber of vascular structures, thickened epididymis, hypoechoic and peripheral vascularization.
Anechogenic content with mobile echogenic content compatible with complicated hydrocele (pyocele and hematocele...) was observed.
Urgent surgical exploration revealed hematocele and thickening with induration of testicular vaginalis.
Intraoperative pathology revealed mucinous adenocarcinoma.
Right radical orchiectomy was performed with cord ligation from the scrotum.
Definitive pathological analysis showed a testicular vaginal neoplasia characterized by mucus lakes and epithelial cell groups, mostly with signet ring morphology, without involvement of the epididymis or testis.
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After testicular surgery, chemotherapy with FOLFIRI plus BEVACIZUMAB was administered in the 3rd cycle.
Nine months after orchiectomy, the patient presented hepatic, pancreatic and regional adenopathic progression, presenting suboptimal symptoms.
She died 21 months after diagnosis.
