Open AccessEmphysematous epididymo-orchitis as a camouflage of prostate invasion secondary to rectum cancer
Author(s) -
Ching-Heng Yen,
Chin-Yu Liu,
TaiLung Cha,
ShengTang Wu,
En Meng,
GuangHuan Sun,
DahShyong Yü,
HongI Chen,
SunYran Chang,
ChihWei Tsao
Publication year - 2016
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000004385
Subject(s) - medicine , rectum , prostate cancer , abdominoperineal resection , exploratory laparotomy , scrotum , surgery , colorectal cancer , cancer
Emphysematous epididymo-orchitis is a rare cause of acute scrotum pain characterized by gas formation within the tissue. Diabetes mellitus and recto-seminal fistula secondary to sigmoid diverticulitis are generally accepted as being responsible for this disease. However, prostate invasion secondary to rectal cancer may be considered to be a newly identified pathogenetic mechanism. Herein, we report this rare case and illustrate the pathogenesis. Case presentation: A 69-year-old man arrived at our emergency department presenting with sepsis and acute scrotal pain. Emphysematous epididymo-orchitis was diagnosed by scrotal sonography initially; however, advanced rectal cancer with prostate invasion was diagnosed by CT after a recurrent episode. An exploratory laparotomy with abdominoperineal resection and radical prostectomy were performed after neoadjuvant chemoradiotherapy. Histopathologic analysis confirmed the previous diagnosis. Emphysematous epididymo-orchitis caused by advanced rectal cancer is very rare, and our case is the first to be reported according to a literature search. Neoadjuvant chemoradiotherapy plus extended surgery can achieve a good oncological outcome. Conclusion: This case indicated that the very rare presentation as emphysematous epididymo-orchitis caused by locally advanced colorectal cancer.