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

Kyratzi, Irene; Lolis, Evangelos; Antypa, Eleni; Lianou, M; Exarhos, Demetrios

doi:10.4329/wjr.v3.i4.114

Cited by 19 publications

(22 citation statements)

References 18 publications

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“…Only about 115 cases of spermatic cord leiomyosarcoma have been reported in the world literature, and only about 43 cases in the English literature. [4][5][6][7][8][9] Thus, the present case seems important, because the present case adds a case in the lists of spermatic cord leiomyosarcoma. Immunohistochemically, the present tumor was positive for vimentin, α-smooth muscle actin, h-caldesmon, desmin (focal), p53, and Ki-67 antigen (labeling = 34%), but negative for pancytokeratin AE1/3, pancytokeratin CAM5.2, KIT (CD117), CD34, S100 protein, and myoglobin.…”

Section: Discussionmentioning

confidence: 99%

“…Negative KIT excludes sarcomatoid small cell carcinoma, sarcomatoid germ cell tumor, and sarcomatous malignant melanoma. [7] Negative KIT and CD34 demonstrate that this case is not extra-gastrointestinal tumor.…”

Section: Discussionmentioning

confidence: 99%

“…The most recent study also reported that there are only about 115 cases of leiomyosarcoma of the spermatic cord in the world literature. [4][5][6][7] This pathological entity in spermatic cord was first reported by Wessel in 1953. [8] All of these reported cases of leiomyosarcoma in spermatic cord are case reports, and there have been no comprehensive studies using many cases.…”

Section: Introductionmentioning

confidence: 99%

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Leiomyosarcoma of the spermatic cord

Terada

2016

CRCP

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Leiomyosarcoma of spermatic cord is very rare. The patient is 65-year-old man who presented with a tumor in scrotum. Excision of tumor was performed and it showed a solid tumor measuring 4 cm × 3 cm × 3 cm in left spermatic cord. Histologically, it showed proliferation of hypercellular atypical spindle cells with hyperchromatic nuclei. The tumor cells were arranged with fascicles of cigar-shaped spindled cells with scant acidophilic cytoplasm. The tumor was not encapsulated, and mild invasive features into surrounding tissue were noted. The mitotic index was 17; 17 mitotic figures were seen in 10 high-power-fields. Atypical mitosis was also seen. Immunohistochemically, tumor cells were positive for vimentin, α-smooth muscle actin, hcaldesmon, desmin (focal), p53, and Ki-67 (labeling index = 34%). No other tumors were identified in the body, and the patient further treated with auxiliary local radiation and chemotherapy (cisplatin and doxorubicin). He is now healthy and free from tumors in the body 15 months after the operation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Leiomyosarcoma of the spermatic cord

Terada

2016

CRCP

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“…10 Immunohistochemical staining is frequently positive for smooth muscle actin and desmin and there may be expression of CD-34 and cytokeratin.…”

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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“…This neoplasm can arise from any smooth muscle layers that are normally found in this region, e.g. cremasteric muscle of spermatic cord [4,5]. Another site of potential origin for leiomyosarcoma is a dartos muscle layer, which closely www.fhc.viamedica.pl adheres to the skin of scrotum [6].…”

Section: Introductionmentioning

confidence: 99%

Role of immunohistochemical and histochemical profiling in H&E-based diagnosis of scrotal leiomyosarcoma of dartos muscle

Wincewicz

Lewitowicz²,

Sulkowska³

et al. 2014

Folia Histochem Cytobiol.

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Histochemical and immunohistochemical methods should often but not always complement standardized histopathologic procedures. Here, we illustrate use of these ancillary techniques in a report of scrotal leiomyosarcoma. 62-year-old male patient presented with a palpable, subcutaneous 2,5 cm wide tumor arising from dartos muscle. The tumor was diagnosed leiomyosarcoma G2 pT1b. Interestingly, the sarcomatous mass was focally strictly attached to convoluted, benign bundles of smooth muscles that were intermingled with tumor mass at peripheral, lateral and superior sides of the lesion. We have used immune-and histochemical methods to confirm histopathological findings based on H&E staining. As expected, in tumor cells smooth muscle actin and desmin were strongly immunopositive similarly as Masson trichrome staining, while S100 and CD34 antigens were immunonegative except for sustained positivity for CD34 in vessels. The auxiliary staining methods can provide additional information on the tumorigenesis of leiomyosarcoma. They can also serve to determine additional features of prognostic significance, since e.g. immunoreactivity of CD34 accurately maps vascular density of tumor and enables a careful assessment of vascular invasion in course of leiomyosarcoma as well.

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

Cited by 19 publications

References 18 publications

Leiomyosarcoma of the spermatic cord

Leiomyosarcoma of the spermatic cord

The rarest form of Paratesticular Leiomyosarcoma – a case report

Role of immunohistochemical and histochemical profiling in H&E-based diagnosis of scrotal leiomyosarcoma of dartos muscle

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