Subject(s)
Anticoagulants/adverse effects , Blood Coagulation Factors/adverse effects , Gastrointestinal Hemorrhage/therapy , Heart Valve Prosthesis , Splenic Infarction/etiology , Warfarin/adverse effects , Anticoagulants/therapeutic use , Aortic Valve/surgery , Blood Coagulation Factors/therapeutic use , Echocardiography , Echocardiography, Transesophageal , Gastrointestinal Hemorrhage/chemically induced , Heparin/therapeutic use , Humans , Infusions, Intravenous , Male , Middle Aged , Partial Thromboplastin Time , Splenic Infarction/drug therapy , Tomography, X-Ray Computed , Warfarin/therapeutic useABSTRACT
Isolated testicular metastasis from rectal cancer is rare. We describe the case of a patient who presented with a locally advanced rectal malignancy and underwent multimodality treatment with low anterior resection, postoperative radiotherapy and adjuvant chemotherapy. He developed a painless testicular nodule while on follow-up, five years after the diagnosis of primary rectal cancer. Histopathology and immunohistochemistry of orchidectomy specimen were compatible with a metastatic adenocarcinoma of rectal origin. We hypothesize that this phenomenon of isolated relapse in a sanctuary site could be due to the altered biology and pattern of metastasis as a result of effective adjuvant systemic chemotherapy. Treatment of late isolated relapse in the testis needs to be ascertained.
