Simultaneous Presence of Testicular Cancer and Alpha Fetoprotein Secreting Colon Cancer
Colon cancer is among the five most common cancers of the human but alpha fetoprotein (AFP)-producing colon cancer is very rare, and this type of cancer frequently metastasis to liver with a poor prognosis. There are some reports about occurrence of colon cancer and testicular cancer in different times. The patient is a 41 years old male was presented with intermittent rectorrhagia. In colonoscopy, he had a mass in descending colon with adenocarcinoma histology. He had a concurrent pain and heaviness in right testicular region. Sonographic examination revealed right testicular mass and after further evaluation of this mass, the diagnosis was seminomatous testicular cancer. He had elevated levels of AFP and immunohistological study of colon cancer tissue established presence of AFP in tumoral cells. His abdominal CT scan showed a hypodense lesion in right liver lobe. He underwent concurrent colectomy and orchiectomy and at the time of surgery he had one liver mass with adhesion to inferior vena cava that its pathologic study confirmed metastatic adenocarcinoma. In spite of Folfox chemotherapy and metastatectomy of the liver mass, He died from progressive metastatic disease in a short time thereafter. To the best of our knowledge this is the first case of an AFP producing colon cancer simultaneous with testicular cancer in the same person. Also in a patient with colon cancer and a testicular mass, testicular germ cell tumors must be in differential diagnosis with other causes such as metastatic colon cancer to testis.
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