Abstract
We describe a rare instance of spermatic cord metastasis in a 30-year-old male with a history of colorectal adenocarcinoma. Despite undergoing left hemi-colectomy and adjuvant chemotherapy, the patient presented 5 years later with right groin pain and swelling, accompanied by rising carcinoembryonic antigen (CEA) levels. Imaging and histopathological examination confirmed metastatic adenocarcinoma. The patient underwent a right sided high inguinal orchidectomy for the same followed by a course of adjuvant chemotherapy. A year later, a second recurrence was identified close to the surgical scar site, following which he underwent re-surgery followed by adjuvant chemotherapy. This case underscores the importance of long-term surveillance in colorectal cancer patients, particularly those with lymphovascular invasion (LVI), and highlights the need to consider atypical metastatic sites in follow-up assessments. Additionally, atypical clinical symptoms should be assessed cautiously as they may preclude a more insidious etiology and require a thorough assessment by the oncologist.