case_images: PMC10515214_01
case_images: Color Doppler US image shows a few of color flow signal at the intratesticular tissue. (A) The right testicle was enlarged and axial position changed. (B) The blood flow signal in the testis was significantly reduced. (C) The boundary between epididymis and testis is not clear.
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case_images: Testicular ischemia in the enlarged right scrotum was observed by color Doppler ultrasound ( Figure 1 ).
case_images: (A) The gross specimen shows a diffusely enlarged testis which have an unclear boundary from the epididymis. (B) Hematoxylin-eosin staining(HEx200) shows signet-ring cells characterized by large cytoplasmic vacuoles indenting the nucleus, appearing either empty clear or containing a droplet of mucin. (C) positivity by immunohistochemistry showed positive expression of Villin-2 proteinconfirmed the epithelial and gastrointestinal origin.
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case_images: Postoperatively, the tumor of the right testis was diagnosed as intestinal-type adenocarcinoma with mucinous and signet-ring cell features by pathologists ( Figure 2 ).
case_images: (A, B) Colonoscopy and examination showed that the ileocecal mucous membrane was edema and ero- sion, with nodular surface changes and unclear boundary involving the opening of the appendix. (C) Pathological examination ((HE,x20)) revealed signet ring cell carcinoma of ileocecal part.
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case_images: The pathology of the biopsy revealed poorly differentiated adenocarcinoma with signet-ring cell features similar to those in the excised testicular specimen ( Figure 3 ).
case_images: Laparoscopic exploration revealed a large number of metastatic nodules in peritoneum, greatero- mentum, small intestine and liver. (A) gross specimen of greateromentum. (B, C) Histopathological examination of the omentum revealed met- astatic signet ring cell carcinoma.
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case_images: The patient underwent an exploratory laparoscopic approach that revealed extensive peritoneal metastasis of the tumor ( Figure 4 ).