case_images: PMC11026633_01
case_images: (A) Normal size of the right testicle, regular morphology, clear contour, smooth envelope, no apparent focal lesions in the parenchyma, and scattered free fluid hypoechoic areas visible around the testicle. (B) Visible patchy free fluid hypoechoic area around the testicle and spermatic cord, measuring approximately 4.31*1.48 cm, with good through-transmission internally.
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case_images: Subsequent ultrasonography confirmed the diagnosis of testicular tunica vaginalis hydrocele, with no apparent occupancies in the testis, epididymis, or spermatic cord ( Figure 1 ).
case_images: (A) Left testicular tunica albuginea fibrous capsule-like tissue with occasional atypical glandular structures in the interstitium, suggestive of a tumor; Right testicular tunica albuginea and appendage tissue reveal atypical glandular structures, indicating a possibility of metastatic adenoma, considering the immunohistochemical results, likely of gastrointestinal origin; (B) tissue biopsy confirmed adenocarcinoma of the sigmoid colon; (C) Colon adenocarcinoma with differentiation in the transverse colon, post-chemotherapy, measuring approximately 2.1*1cm in size.The Immunohistochemical results is same: CK7-,CK20+,PSA-,MLH1+,MSH2+,MSH6+,PMS2+,c-erbB-2(GC) -,BRAF(-).
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case_images: Pathological results indicated a potential digestive tract metastatic carcinoma( Figure 2 ). we proceeded to inquire further into the medical history. Postoperatively, pathological examination confirmed moderately differentiated adenocarcinoma of the sigmoid colon( Figure 2 ), no special type, and immunohistochemistry revealed: P53 (+), ki67 (50%), MLH1 (present), PMS2 (present), MSH2 (present), MSH6 (present).
case_images: A semi-circumferential mass is observed at a distance of 20 cm from the anus, accompanied by localized intestinal wall torsion and slight mucosal stiffness.
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case_images: f3
case_images: Subsequently, a colonoscopy revealed a tumor located 20 cm from the anal verge, and tissue biopsy confirmed adenocarcinoma of the sigmoid colon( Figure 3 ).
case_images: Local thickening of the transverse colon and sigmoid colon with concomitant elevated glucose metabolism, raising consideration for cancer; multiple soft tissue nodules with abnormal glucose metabolism in the peritoneal omentum, prompting consideration of metastatic carcinoma.
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case_images: Figure 4 ). Following a detailed assessment of tumor metastasis, the hospital organized a multidisciplinary team (MDT) discussion, ultimately determining the treatment plan as XELOX (capecitabine and oxaliplatin) combined with bevacizumab.