Right cryptorchid testicular metastasis from descending colon carcinoma: a case report of “Krukenberg tumor” in male

three lymph nodes was also found in 14 examined mesenteric lymph nodes. The patient received postoperative chemotherapy that consisted of 12 cycles of mFOLFOX6. He was doing well during follow-ups and remained no recurrence at 20 months after surgery. Reports on metastatic cancer of the testis, as analog Krukenberg tumor in male, are rare. Cryptorchid testicular metastasis, as a special type of testicular metastasis, scarcely has been reported. We searched the medical literature using the MEDLINE/PubMed database from 1950 to 2013. Our search yielded two cases of cryptorchid testicular metastasis, both from colon cancer. Rampa et al. 7 reported a case of metastatic carcinoma from the sigmoid colon to the left cryptorchid testis. In another Spanish paper, Alvarez Pérez et al. 8 reported a case of metastasis of carcinoma from the colon to cryptorchid testis. We described here for the first time, a metastasis of descending colon adenocarcinoma to the right cryptorchid testis. Various pathways have been supposed as routes of cancer spread leading to the development of Krukenberg tumor. These include lymphatic spread, hematogenous spread, direct invasion, peritoneal seeding, etc. Al-Agha and Nicastri 1 considered that retrograde lymphatic spread is the most likely route of metastasis. But Jun and Park 9 reported the incidence of hematogenous recurrence was the highest. Other less common pathways of metastasis to the ovary occur via the peritoneum and vasculature. In male, the route for the spread of metastasis to the testes might be similar. Some possible pathways have been reported, including a retrograde lymphatic extension, direct invasion or extension from the original lesion, arterial and venous embolization from the tumor, and retrograde spermiduct extension. 12 Our case showed that the testicular maldescending led to an insufficient obliteration of the peritoneal gap in the abdominal inguinal ring and generated a patent processus vaginalis. This might provide a potential route for gastrointestinal tumors spread through the patent processus vaginalis to testis. Therefore, our case provided a new pathway for the development of " Krukenberg tumor " in male. The incidence of " Krukenberg tumor " in male is lower than that in female. Yada-Hashimoto et al. 6 found that metastatic tumors accounted for 21.1% (64/304) of malignant ovarian tumors. While metastatic carcinoma to the testes is extremely rare, the incidence rates vary from 0.02% to 2.5%. 13 Such a big difference might be explained in two reasons at least. One reason is that the sufficient …