Scrotal metastasis of colorectal carcinoma with unusual presentation and late recurrences: A study from a tertiary care oncology center in India.

Background: Colorectal carcinoma (CRC) is a common malignancy, frequently metastasizing to the liver, lungs, and regional lymph nodes. However, metastasis to the scrotum is exceedingly rare, with few cases reported in the literature. In this study, we present a series of five cases of CRC metastasizing to the scrotum, emphasizing their unusual clinical presentation and late recurrences.

Methods: We did a retrospective review of 7 years from 2015 to 2022 for cases of scrotal metastasis in cases of CRC.

Results: The mean age in our study was 38 years (22-61 years) and the median time interval between the primary diagnosis and scrotal metastasis was 31.6 months (0-104 months). The cases include scrotal swelling initially misdiagnosed as a hydrocele (case 1), nonhealing cutaneous ulcers (cases 3 and 5), a scrotal skin papilloma (case 4), and a cutaneous nodule (case 2).

Conclusion: This series of five cases highlights the rarity and diagnostic challenges associated with CRC metastasizing to the scrotum. The extended latency between primary tumor diagnosis and scrotal metastasis, coupled with atypical clinical presentations, underscores the importance of maintaining a high index of suspicion. Clinicians should be vigilant, especially when evaluating patients with a history of CRC, to promptly identify such uncommon metastatic sites.