The patient, male, 65 years old, came to our hospital on April 19, 2005 with “vague pain and abdominal distension in the right lower abdomen for 9 months”. On examination: a 200 px sized mass was palpated in the right lower abdomen, with medium quality, unclear border, activity and local pressure pain. External colonoscopy showed: a bulging mass at the beginning of the cecum, occupying one week of the intestinal lumen. Pathology report showed that a small number of highly suspicious cancer cells were found in the mucosal layer of the intestine in the ileocecal region. Post-admission examination: CA199 173.53 Ku/L, CA242 128.86 Ku/L, CEA 11.69 ng/ml. CT of the lower abdomen showed a 175px×200px irregular mass in the right lower abdominal ileocecal region, with irregular thickening of the intestinal wall, unclear surrounding boundary, punctate calcification and low density shadow, and irregular enhancement after enhancement. The diagnosis was “carcinoma of the ileocecal region”, and the right hemicolectomy was performed under general anesthesia one week later. Postoperative pathology: the resected intestine was 800px long, and the tumor was located in the ileocecal region, 475px away from the superior incision, 175px×175px in size. ulcerative infiltration type, the tumor surrounded the intestinal wall for 3/4 weeks. (Right hemicolectomy) Mucinous adenocarcinoma, penetrating the whole layer to reach the extraplasma adipose tissue. Tumor immunoenzymatic labeling results: P53, CEA (+), PCNA 40% (+), Ki-67 1% (+), CerbB-2, S100, CD34 (-). Intralymphovascular cancer infiltration (+), intravascular cancer infiltration (-), perineural cancer infiltration (-). Lymph node immune response status: SH (+), PH (+), GH (+). Postoperative chemotherapy was administered. One year after surgery, the patient came to our hospital again with progressive enlargement of the right scrotum for 3 months. Ultrasound examination showed that the mass was located above the right testicle, most of which was cystic and a small part was substantial. The fluid in the capsule was cloudy with poor transmission, the capsule wall was gross, papillary protrusions were seen with irregular morphology, and no abnormal blood flow signal was observed. thcG and CEA were normal. CT of pelvis showed that there were no obvious enlarged lymph nodes in pelvis, no obvious fluid in pelvis, thickening of right spermatic cord, and uneven high-density mass in right scrotum, which was enhanced after enhancement, combined with medical history, metastasis of right testicular spermatic cord from ileal carcinoma was considered. The right scrotal exploration was performed after completing all relevant examinations. Intraoperatively, a thickened spermatic cord and a 50px×75px sized neoplastic mass with papillary shape were seen. The right testicular spermatic cord tumor was then radically resected. Postoperative pathology diagnosed metastatic mucinous adenocarcinoma of the testis seminiferous cord. Postoperative chemotherapy was continued. Discussion Most malignant tumors of the spermatic cord are sarcomas, and metastatic malignant tumors are very rare, mostly originating from the prostate, kidney, lung, bladder, etc., and usually accompanied by metastatic lesions in the testis and epididymis. Metastases from the digestive tract to the spermatic cord or scrotum are extremely rare, and most often arise from the stomach, most often to the spermatic cord. The route of tumor metastasis is not known, but may be related to the reverse flow of lymphatic fluid. For example, right hemi-colon cancer may metastasize to the root of superior mesenteric artery with lymphatic fluid, then metastasize to the lymph nodes adjacent to the abdominal aorta and metastasize retrogradely to the spermatic cord. In this case, the tumor originated from the ileocecal region, and only one case was reported by Nishimura in a 71-year-old man with metastasis to the right spermatic cord one month after right hemicolectomy for cecum cancer.