Paratesticular leiomyosarcoma treated by enucleation

Lopes, Roberto Iglesias; Leite, Kátia Ramos Moreira; Lopes, Roberto Nicomedes

doi:10.1590/s1677-55382006000100011

Cited by 21 publications

(21 citation statements)

References 4 publications

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“…Bu oranlar tüm genitoüriner tümörlerin %1-2'sini oluşturmaktadır. Leiomyosarkomlar paratestiküler sarkomların %10'unu oluşturmaktadırlar [4,5]. Bu tümörler üroloji pratiğin-de nadir görüldükleri için tanıda sıklıkla ilk planda düşünülme-mektedirler.…”

Section: Introductionunclassified

Paratesticular Leiomyosarcoma: A Case Report and Review of the Literature

Erdemır¹

2012

Ann Clin Anal Med

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ÖzetSpermatik kord kaynaklı leiomyosarkomlar oldukça nadir görülmektedir. Altmış beş yaşında erkek hasta 4 aydır olan ağrısız sağ inguinal kitle şikayeti ile kliniğimize başvurdu. Hastanın herhangi bir üriner sistem semptomu veya travma öy-küsü yoktu. Fizik muayenede inguinal bölgede yaklaşık 3x5 cm boyutlarında sert, mobil ve hassas olmayan kitle saptandı. İnguinal herni tespit edilmedi. Testiküler tümör belirteçlerine (αFP, beta HCG) ilave olarak diğer rutin biyokimyasal ve hematolojik tetkikler normal sınırlar içindeydi. Skrotal ve inguinal bölge ultrasonografisinde sağ inguinal bölgede yaklaşık 44x30x54 mm boyutlarında spesifik olmayan heterojen yapıda kitle saptandı. Sağ testis ve epididim normal olarak rapor edildi. Hastaya inguinal yaklaşımla internal inguinal ring seviyesinde kord ligasyonu ile radikal orşiektomi yapıldı. Ayrıca herni onarımıda yapıldı. Patolojik inceleme paratestiküler leiomyosarkom olarak rapor edildi. Bu patoloji sonucunda adjuvan kemoterapi veya radyoterapi verilmesi düşünülmedi. Operasyon sonrası 6. ayda lokal nüks veya uzak metastaz saptanmadı. Sonuç olarak spermatik kord sarkomları her ne kadar oldukça nadir olarak görülselerde özellikle yaşlı erkeklerde palpabl skrotal ya da inguinal kitlelerin ayırıcı tanılarında daima gözönünde bulundurulmalıdırlar. Anahtar KelimelerSpermatik Kord; Paratestiküler Tümör; Leiomyosarkom; Tedavi Abstract Leiomyosarcomas arising from the spermatic cord are extremely rare. A 65 year old man admitted to our clinic with a 4 months history of painless right inguinal mass. He had no history of trauma and no urinary tract symptoms. On physical examination a firm non-tender mobile mass of approximataly 3x5 cm in diamater was found in inguinal region. No inguinal hernia was detected. In addition to testicular tumor markers (αFP, beta HCG), routine hematologic and biochemical analysis were within normal ranges. Ultrasonography of the scrotum and inguinal region showed a non-specific, heteroechogenic mass of approximately 44x30x54 mm in diamater on the right inguinal region. The right testis and epididymis were normal. It was treated by radical orchiectomy with ligation of the spermatic cord at the level of internal inguinal ring through an inguinal approach. The patient also underwent herniorraphy. Pathological study revealed that paratesticular leiomyosarcoma. After this pathology report we did not consider adjuvant chemotherapy or radiotheraphy. Six months postoperatively there was no evidence of local recurrence of the neoplasm or distant metastasis. As a result we can say that although spermatic cord leiomyosarcoma is extremely rarely seen this tumor should be considered in the differential diagnosis of palpable masses on the scrotal or inguinal region especially in older men.

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Section: Introductionunclassified

Paratesticular Leiomyosarcoma: A Case Report and Review of the Literature

Erdemır¹

2012

Ann Clin Anal Med

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“…The primary treatment with radical orchidectomy is an essential approach, but a single case report with local excision and surveillance has been reported. 5 A reported survival rate is 50%-80% and it has been observed that simple excision is suboptimal as repeat wide excision has demonstrated microscopic residual disease in 27% of cases and therefore warrants an additional adjuvant treatment. 6 A wide excision is almost mandatory if negative histological margins are not achieved during primary surgery.…”

Section: Discussionmentioning

confidence: 99%

Leiomyosarcoma of the spermatic cord: case report and literature review

Dangle

Basavaraj

Bhattarai

et al. 2012

CUAJ

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The testis and epididymis were separate from the lesion. The lump was dissected from the cord structure. The cut surface was white, solid and hard to the touch. The testis was repositioned in the scrotum and the inguinal incision was closed in layers. The patient's postoperative recovery was uneventful.Microscopic examination revealed cells arranged in well defined fascicles with central hyperchromatic nuclei and a moderate amount of eosinophilic cytoplasm (Fig. 2). There were 4 mitoses per 10 high power fields. Small foci of necrosis were noted with the appearances of a spindle cell lesion of probable smooth muscle origin. The high cellularity, pleomorphism, necrosis and mitotic activity suggested this was a malignant tumour. The tumour was classified as a grade 2 (differentiation = 2, mitoses = 1, necrosis = 1) on the Fédération Nationale des Centres de Lutte Contre le Cancer system. These histological features were suggestive of a leiomyosarcoma. The immunohistochemistry revealed interlacing fascicles of smooth muscle (positive for desmin, smooth actin and negative for S 100) ( Fig. 3A and Fig. 3B). The histology showed infiltration at edges with margins positive for tumour.The diagnosis of leiomyosarcoma and positive margin on histology prompted us to refer the patient to the regional sarcoma clinic for further treatment. His staging CT san of the chest, abdomen and pelvis did not reveal any local or distant tumour. Subsequently, he underwent a left radical orchidectomy with histology showing fibrosis of the spermatic Case ReportA 51-year-old man presented with a 2-year history of painless lump in the left hemiscrotum. He had no history of trauma, sudden increase in size or associated pain. The patient denied any lower urinary tract symptoms. His previous medical history included recurrent renal stone disease. Clinical examination of the scrotum revealed a 3 cm, non-tender, firm-to-hard lump at the root of the scrotum separate from the left testis. The lump was not freely mobile and was attached to the left spermatic cord. The routine blood investigations were normal. Ultrasound scan of the scrotum showed normal appearance on the right side, with a distinct and well circumscribed 4 × 3.2 × 2.5 cm lesion of mixed heterogeneous echogenicity on the left side. It was abutting the upper pole of the left epididymal head but separate from the epididymis and the testis. The lesion itself showed increased vascularity (Fig. 1A and Fig. 1B).The patient was offered a radical orchidectomy along with excision of the spermatic cord mass, but he declined to have an orchidectomy and opted only for excision of the mass. Upon operating we discovered that he had a lump arising from the cord near the root of the left hemiscrotum. AbstractA 51-year-old man presented with a 2-year history of painless lump in the left hemiscrotum. Scrotal examination demonstrated a 3-cm, firm-to-hard mass attached to the left spermatic cord. Scrotal ultrasound scan revealed a heterogeneous mass separate from the left testis and epididymis. An orch...

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“…The majority of the LMSs described in the literature are heterogeneous lesions like the aforementioned [6,11,15,16] although some LMSs appear to be hypoechoic [8,14] . Calcifications are not mentioned in the majority of the cases described [1,2,6,8,11,[14][15][16] . Colour Doppler ultrasonography shows either minimal [8] , or increased vascularity [11,16] .…”

Section: Discussionmentioning

confidence: 99%

“…The spermatic cord is the most common site of extratesticular neoplasia but only 30% of them are malignant, 90% of which are sarcomas. Approximately 10% of paratesticular sarcomas are LMSs [2] . This type of lesion is reported in all age groups but is mostly diagnosed in the 6th decade [3] .…”

Section: Introductionmentioning

confidence: 99%

Imaging features of a huge spermatic cord leiomyosarcoma: Review of the literature

Kyratzi

Lolis²,

Antypa³

et al. 2011

WJR

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Spermatic cord leiomyosarcomas (LMSs) are rare tumors which may cause significant morbidity and mortality if inadequately diagnosed or treated. We report a case of a paratesticular LMS in a 60-year-old man who presented with a right scrotal mass. The patient was evaluated by scrotal ultrasound and computed tomography of the abdomen and pelvis (including scans of the scrotum), which revealed a large extratesticular mass. The lesion proved to be malignant and the patient underwent radical orchiectomy with high cord ligation. To improve the assignment of this lesion, we further analyze the imaging features of LMS and correlate them with pathologic findings.

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Paratesticular leiomyosarcoma treated by enucleation

Cited by 21 publications

References 4 publications

Paratesticular Leiomyosarcoma: A Case Report and Review of the Literature

Paratesticular Leiomyosarcoma: A Case Report and Review of the Literature

Leiomyosarcoma of the spermatic cord: case report and literature review

Imaging features of a huge spermatic cord leiomyosarcoma: Review of the literature

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