A male patient, 53 years old, was admitted to the hospital on April 13, 2023, with complaints of redness, swelling, and pain in the perineum and scrotum for five days after targeted combination chemotherapy for rectal cancer. The patient had a 6-month history of rectal cancer (cT4bN + M1a, stage IVA). Genetic testing revealed KRAS mutation, NRAS, wild-type BRAF, and MSS. bevacizumab + CapeOX regimen chemotherapy for 3 cycles, specifically bevacizumab 500 mg d1 oxaliplatin 200 mg d1 + capecitabine 15 g bid d1-14, repeated for 21 days. CT examination on April 13, 2023, showed the following: 1. Combined with the clinic, the pelvic cavity showed retroperitoneal and left supraclavicular lymph node metastasis after treatment for rectal cancer. 2. Enlarged left hilar and mediastinal lymph nodes are recommended for observation. All of the above changes from March 13, 2023, are not significant. 3. Consider the left lower abdominal wall the right perineum, and scrotal infection (Fig. 1A, B, and C); scanning the field of the right armpit, right cervical root, bilateral chest wall, abdominal wall (Fig. 2A, B), subcutaneous buttocks and inguinal area, scrotal pneumatosis (Fig. 1), please take into account the clinical aspects. On April 18, 2023, procalcitonin test (blood): procalcitonin 1.4 ng/L. blood routine examination: white blood cell count 13.51×109/L, neutrophil count 11.77×109/L, red blood cell count 3.41×1012/L, hemoglobin 115 g/L, platelet count 195×109/L, procalcitonin test (blood): procalcitonin 2.69 ng/L, B-type natriuretic peptide 360.00pg/m. After excluding contraindications to surgery, laparoscopic sigmoid colostomy, intestinal adhesion release, and bilateral orchiectomy perineum repair were performed under general anesthesia(Fig. 3A and B) on April 20, 2023, and postoperative symptomatic treatment was administered. Postoperative review of procalcitonin April 21, 2023 procalcitonin test (blood): procalcitonin 0.39 ng/L. Postoperative pathology on April 24, 2023, showed: (bilateral testes and perineum-infected tissue) fibrous tissue hyperplasia, with a large amount of acute and chronic inflammatory cell infiltration, vascular hyperplasia, congestion, focal necrosis, and small abscess formation. Postoperatively, the patient's procalcitonin status and various blood indices were continuously observed and compared with the preoperative period (Figs. 4 and 5). Leukocytes were significantly elevated at the peak of the infection, and red blood cells and serum iron levels were reduced. The patient developed infectious anemia. The patient was discharged from the hospital in stable condition after surgery. After discharge, the patient underwent skin grafting at the Qilu Hospital of Shandong Province with good results (Fig. 3C).