An unusual initial presentation of colorectal cancer: abdominal wall and scrotal abscess associated with right ventricular metastasis
Abstract
A 56-year-old man presented to the emergency department with a painful abdominal lump with redness of the overlying skin in the right iliac fossa, swelling, and redness of the scrotum. Laboratory tests revealed a marked increase in white blood cell count (50.73x109/L), neutrophil count (48.18x109/L), and C-reactive protein levels (37.36 mg/dL). Abdominal contrast-enhanced Computed Tomography (CT) scan showed a voluminous neoplastic lesion involving the ascending colon, the cecum, and the last ileal loop, which was in communication with a large abscess located in the anterior abdominal wall and extended craniocaudal up to the right scrotum; a mass within the right ventricle was also seen. The patient underwent a right hemicolectomy and a right orchiectomy. Histological examination revealed a low-grade mucinous adenocarcinoma of the right colon as well as a significant abscess of the right testis' tunica vaginalis. The patient died one month after surgery.
References
- Xi Y, Xu P. Global colorectal cancer burden in 2020 and projections to 2040. Transl Oncol 2021;14:101174. DOI: https://doi.org/10.1016/j.tranon.2021.101174
- Cautha S, Gupta S, Moirangthem V, et al. Presentation of colorectal carcinoma as abdominal wall phlegmon. J Investig Med High Impact Case Rep 2023;11:23247096221144974. DOI: https://doi.org/10.1177/23247096221144974
- Attar L, Trabulsi N, Maghrabi AA, Nassif M. Adenocarcinoma of the colon disguised as abdominal wall abscess: case report and review of the literature. Case Rep Surg 2018;2018:1974627. DOI: https://doi.org/10.1155/2018/1974627
- Bischoff K, López C, Shaffer K, Schwaitzberg S. Colorectal adenocarcinoma presenting as abdominal wall cellulitis. Radiol Case Rep 2008;3:204. DOI: https://doi.org/10.2484/rcr.v3i3.204
- Panchagnula K, Yalla P, Lakshminarayana B, et al. Anterior abdominal wall abscess: an unusual presentation of carcinoma of the colon. Arch Surg Clin Res 2019;3:70-1. DOI: https://doi.org/10.29328/journal.ascr.1001038
- Basukala S, Thapa N, Rayamajhi BB, et al. A rare presentation of perforated carcinoma of colon as an anterior abdominal wall abscess-a case report and review of literature. J Surg Case Rep 2021;2021:rjab344. DOI: https://doi.org/10.1093/jscr/rjab344
- Bussani R, De-Giorgio F, Abbate A, Silvestri F. Cardiac metastases. J Clin Pathol. 2007; 60: 27-34. DOI: https://doi.org/10.1136/jcp.2005.035105
- White AF, Haskin BJ, Jenkins CK, et al. Abscess of the abdominal wall as the presenting sign in carcinoma of the colon. Cancer 1973;32:142-6. DOI: https://doi.org/10.1002/1097-0142(197307)32:1<142::AID-CNCR2820320120>3.0.CO;2-O
- Kim SW, Shin HC, Kim IY, et al. CT findings of colonic complications associated with colon cancer. Korean J Radiol 2010;11:211-21. DOI: https://doi.org/10.3348/kjr.2010.11.2.211
- Gupta R, Meghrajani V, Desai R, Gupta N. Primary malignant cardiac tumors: a rare disease with an adventurous journey. J Am Heart Assoc 2020; 9:e016032. DOI: https://doi.org/10.1161/JAHA.120.016032
- Badheeb A, Ahmed F, Alhosni Y, et al. Metastasis of colorectal adenocarcinoma to the right ventricle in a young man: a case report. Pan Afr Med J 2023;44:32. DOI: https://doi.org/10.11604/pamj.2023.44.32.37999
- Numata K, Urata N, Nakayama Y, et al. solitary cardiac metastasis from colorectal cancer: a case report. Case Rep Oncol 2022;15:798-803. DOI: https://doi.org/10.1159/000526549
Metrics
Citations and online attention from Dimensions, Altmetric and PlumX.
License
Copyright (c) 2024 the Author(s)

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.