Signet Ring Cell Carcinoma of the Colon With Spermatic Cord Metastasis

We report a case of metastatic signet ring cell carcinoma (SRC) of the colon involving the right spermatic cord and testis following a right hemicolectomy. A 53-year-old male presented to our hospital in August 2020 with abdominal distension. Colonoscopy revealed a stenotic tumor in the transverse colon, and curative right hemicolectomy was performed. Histopathological examination confirmed colorectal cancer (CRC), classified as Stage IIIc. Postoperatively, capecitabine was administered for six months. In October 2021, the patient revisited our hospital with right scrotal swelling and pain. Although tumor markers were negative, CT revealed a tumor in the spermatic cord. Subsequently, orchiectomy and spermatic cord excision were performed. Histopathological findings confirmed SRC, consistent with the primary colon cancer diagnosed at age 53, and the lesion was considered a metastasis. This case represents an extremely rare occurrence of CRC of the colon, further complicated by metastasis to the spermatic cord, an uncommon metastatic site for CRC.