Location
Philadelphia, PA
Start Date
1-5-2024 1:00 PM
End Date
1-5-2024 4:00 PM
Description
Large bowel obstructions can occur in many settings, including a volvulus, adhesive disease, strictures, hernias, and malignancy. In the setting of malignancy, a bowel resection is the most common initial treatment option, and histologic examination of the resected specimen can identify the underlying source of the obstructing mass. Most commonly, large bowel obstruction is due to colorectal cancer, and if metastasis is present, it will most commonly involve the liver, followed by the lungs, bone, and brain. We present a case of a 36-year-old male who presents with a large bowel obstruction and a testicular mass noted on admission. The patient underwent a left hemicolectomy with ostomy creation to resolve the bowel obstruction and an orchiectomy to investigate the testicular mass. Testicular cancer typically metastasizes to retroperitoneal lymph nodes, and soft tissue metastasis is extremely rare. At the point of resection for this patient, these masses were suspicious for primary testicular cancer and primary colorectal cancer. Surprisingly, this combination of a large bowel obstruction and a testicular mass revealed an underlying B-cell lymphoma. This case exhibits a rare presentation of B-cell lymphoma with large bowel obstruction and a testicular mass. Although rare, with early recognition, high-grade lymphoma in the case of a large bowel obstruction can prevent detrimental outcomes in the long run for the patient.
Embargo Period
6-13-2024
Included in
A rare case of high grade lymphoma presenting as large bowel obstruction with testicular mass
Philadelphia, PA
Large bowel obstructions can occur in many settings, including a volvulus, adhesive disease, strictures, hernias, and malignancy. In the setting of malignancy, a bowel resection is the most common initial treatment option, and histologic examination of the resected specimen can identify the underlying source of the obstructing mass. Most commonly, large bowel obstruction is due to colorectal cancer, and if metastasis is present, it will most commonly involve the liver, followed by the lungs, bone, and brain. We present a case of a 36-year-old male who presents with a large bowel obstruction and a testicular mass noted on admission. The patient underwent a left hemicolectomy with ostomy creation to resolve the bowel obstruction and an orchiectomy to investigate the testicular mass. Testicular cancer typically metastasizes to retroperitoneal lymph nodes, and soft tissue metastasis is extremely rare. At the point of resection for this patient, these masses were suspicious for primary testicular cancer and primary colorectal cancer. Surprisingly, this combination of a large bowel obstruction and a testicular mass revealed an underlying B-cell lymphoma. This case exhibits a rare presentation of B-cell lymphoma with large bowel obstruction and a testicular mass. Although rare, with early recognition, high-grade lymphoma in the case of a large bowel obstruction can prevent detrimental outcomes in the long run for the patient.