A Rare Case of Paratesticular Leiomyosarcoma

Haran, Shankar; Balakrishan, Vikram; Neerhut, Gregory

doi:10.1155/2014/715395

Cited by 7 publications

(11 citation statements)

References 26 publications

(28 reference statements)

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“…Typically, paratesticular leiomyosarcoma presents as a firm nontender scrotal painless mass, independent from the testis on physical examination. Scrotal ultrasound is the primary imaging modality for the evaluation of a scrotal mass, differentiating extratesticular from intratesticular lesions and dismissing several differential diagnoses such as epididymitis, cysts, and hydrocele [ 11 ]. However, with no specific imaging features, preoperative diagnosis remains difficult, and histological examination of the resected specimen is required for definitive diagnosis [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Primary Paratesticular Leiomyosarcoma: A Case Report and Literature Review

Naimi

Zarraa

Kammoun

et al. 2020

Case Reports in Urology

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Paratesticular soft tissue sarcomas are very rare malignant mesenchymal tumors. With only few cases reported in the literature, data regarding diagnostic and management of these tumors are limited. We reported a case of primary paratesticular leiomyosarcoma in a 72-year-old man complaining of a progressively growing painless right scrotal mass. The patient underwent radical inguinal right orchiectomy and adjuvant 3D conformal radiotherapy to the tumor bed including the surgical scar. The prescription dose was 54 Gy, and no pelvic irradiation was performed. He remained free of recurrence for the last 16 months.

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Section: Discussionmentioning

confidence: 99%

Primary Paratesticular Leiomyosarcoma: A Case Report and Literature Review

Naimi

Zarraa

Kammoun

et al. 2020

Case Reports in Urology

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“…5 Leiomyosarcomas are malignant tumours which develop from undifferentiated smooth muscle cells of mesenchymal origin anywhere in the body, rarely presenting as primary paratesticular sarcomas. When tumours are paratesticular, they most commonly arise from the spermatic cord where they originate from cremasteric muscle and the vas deferens.…”

Section: Discussionmentioning

confidence: 99%

The rarest form of Paratesticular Leiomyosarcoma – a case report

Cobley

Mahmalji

2018

JOMH

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Paratesticular tumours make up less than 5% of intra-scrotal tumours and of these, approximately 30% are malignant tumours with sarcomas accounting for the majority.Leiomyosarcoma is a malignant tumour arising from soft tissues containing smooth muscle. They are reported as comprising between 5-30% of paratesticular sarcomas.1,2 It is extremely rare that they arise from tissue other than the spermatic cord or epididymis.The authors describe such a case of paratesticular leiomyosarcoma in a 54-year-old man who presented with a six-month history of a painful testis and who subsequently underwent radical inguinal orchidectomy and high ligation. CASE REPORTA 54-year-old man presented to his doctor with a 6-month history of a painful left testis and was referred to urology. On examination the left testis was palpable anterior to the scrotum with a hard, craggy mass felt posteriorly.Scrotal ultrasound described a 5.9 mm left upper pole mass of mixed echogenicity and increased blood flow from the left testis. Tumour markers were normal.Following multidisciplinary team discussion, a repeat ultrasound was performed by a consultant radiologist with urology expertise. The results indicated a large extratesticular mass likely arising from scrotal layers of uncertain nature but soft tissue sarcoma not ruled out.Computed tomography of the thorax, abdomen, and pelvis showed no evidence of metastasis or lymphadenopathy.After a multidisciplinary team assessment, the patient was counselled for a left radical inguinal orchidectomy. Intra-operatively the tumour was intra-tunical and appeared closely adherent to the testis and spermatic cord which made for a more challenging orchidectomy but the patient made an uneventful recovery and was discharged on post-operative on day 1.Macroscopically, there was a firm, white lobulated tumour measuring 72 × 50 × 50 mm, compressing the testis which measured 40 × 10 mm.Histopathological assessment identified a malignant tumour of the paratesticular region with no connection seen to the testis, rete testis, epididymis, or spermatic cord.Morphological features included plump, spindleshaped cells arranged in fascicular, storiform, and whorled architectural patterns. The nuclei showed coarse chromatin with moderate eosinophilic cytoplasm and exhibited moderate to marked atypia with foci of moderate to severe pleomorphism with multinucleate and large pleomorphic tumour cells. Numerous

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“…Because of low prevalence of this disease, there is limited knowledge about clinical course and management. The clinical course of paratesticular leiomyosarcomas determined by site, size, grade and evidence of metastasis (8,9). High grade tumors behave aggresively (10).…”

Section: Discussionmentioning

confidence: 99%

“…High grade tumors behave aggresively (10). Radical orchiectomy is the standart primary surgical procedure and adjuvant radiation therapy may be effective in controling loco-regional recurrence (2,3,9). About adjuvant or palliative systemic chemotherapy, there is data only from soft tissue sarcomas at other sites of body, doxorubicin-based chemotherapy may be effective, but effect on overall survival is not shown (11).…”

Section: Discussionmentioning

confidence: 99%

Primary Leiomyosarcoma of ParatesticularRegion: Very Good Response to Chemotherapy for Intraabdominal Metastases

Durnalı¹,

Alkış²,

Yazıcı³

et al. 2016

Acta Oncol Tur.

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ÖZETSkrotal leiomyosarkoma nadiren görülür ve paratestiküler veya intratestiküler olabilmektedir. İki yıl önce paratestiküler leiomyosarkoma nedeniyle opere edilmiş olan 18 yaşında erkek hasta rezeke edilemeyen intraabdominal metastazlarla bölümümüze başvurdu. Kombinasyon kemoterapi rejimen (doksorubisin ve mesna korumasıyla birlikte ifosfamid) başlandı ve 6 uygulama sonrasında çok iyi parsiyel regresyon sağlandı. Bizim olgumuz, paratestiküler leiomyosarkomalı hastaların uzun dönem takiplerinin gerekli olduğunu ve metastatik durumda sistemik kemoterapinin çok etkili olabileceğini vurgulamaktadır. Anahtar Kelimeler: Kemoterapi, Metastaz, Paratestiküler leiomyosarkoma ABSTRACT Scrotal leiomyosarcoma is seen rarely and may be paratesticular or intratesticular. An 18-year-old male, operated for paratesticular leiomyosarcoma 2 years before, was referred to our department with unresectable intraabdominal metastases. Combination chemotherapy regimen (ifosfamide with mesna protection and doxorubicin) was started and very good partial regression was achieved after 6 cycles. Our case highlighted that long-term follow-up of the patients with the paratesticular leiomyosarcoma is required and systemic chemotherapy might be very effective in metastatic setting. Keywords:Chemotherapy, Metastasis, Paratesticular leiomyosarcoma Introduction:

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A Rare Case of Paratesticular Leiomyosarcoma

Cited by 7 publications

References 26 publications

Primary Paratesticular Leiomyosarcoma: A Case Report and Literature Review

Primary Paratesticular Leiomyosarcoma: A Case Report and Literature Review

The rarest form of Paratesticular Leiomyosarcoma – a case report

Primary Leiomyosarcoma of ParatesticularRegion: Very Good Response to Chemotherapy for Intraabdominal Metastases

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