Leiomyoma of the Spermatic Cord

Bormel, Paul; Young, John

doi:10.1016/s0022-5347(17)65191-7

Cited by 8 publications

(3 citation statements)

References 2 publications

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“…[1][2][3][4] Extensive review of the literature shows that leiomyoma of the tunica albuginea, tunica vaginalis testis, spermatic cord, epididymis, and body of the testis has been described. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Intratesticular leiomyoma of the body of the testis is extremely rare, and a review of the literature reveals that only two other cases have been reported. 1 The tumor in our case is unique in that it involves almost the entire body of the testis and is so large.…”

Section: Discussionmentioning

confidence: 99%

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Intratesticular leiomyoma of the body of the testis.

Thomas

Rifkin

1998

Journal of Ultrasound in Medicine

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Most solid intratesticular masses are malignant. When a solid lesion is identified on ultrasonography, malignancy must be considered initially; however, besides an intratesticular cyst, benign lesions do exist that sonologists should be aware of. One of the rarest is the intratesticular leiomyoma. We present a case of intratesticular leiomyoma and its sonographic appearance, pathologic findings, and differential diagnosis. CASE REPORTA 52 year old white man with an unremarkable past medical history noticed a gradual, painless increase in the size of his left testicle over a period of 6 months. On physical examination his left testicle was found to be markedly enlarged, hard, and nontender, and it did not transluminate. The right testicle was normal, and the remainder of his physical examination was unremarkable. The patient's CBC, blood chemistry, clotting profile, and AFP, beta HCG, and PSA levels were within normal limits.The scrotal ultrasonogram showed a nonuniform pattern of the enlarged left testicle, with predominantly decreased echogenicity interspersed with areas of hyperechogenicity (Figs. 1, 2). It was moderately vascular on color Doppler imaging (Fig. 3). A moderate amount of left scrotal fluid (hydrocele) was present. The epididymis appeared unremarkable. The right testicle and hemiscrotum were normal.The patient underwent a radical left orchiectomy after an unsuccessful course of antibiotics. At surgery the left testis was found to be enlarged, and a firm mass measuring approximately 6.0 × 3.0 × 4.0 cm was palpable within the testis.Gross sectioning of the testis revealed a large tan spherical mass (Fig. 4). The tumor was well circumscribed, with a sharp interface between the tumor and adjoining uninvolved testis. The cut surface was white to tan in color, with a whorled pattern. No areas of hemorrhage or necrosis were identified.Histologic sections showed that the tumor was com-

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Section: Discussionmentioning

confidence: 99%

“…The cells tend to be packed and overlapping and can be arranged in intertwining fasciculi. [1][2][3][4][5][6][7][10][11][12][13][14]18 Despite the lesion's benign nature, radical orchiectomy remains the treatment of choice, simply because this innocuous lesion cannot be distinguished clinically from the more common testicular malignancy.…”

Section: Discussionmentioning

confidence: 99%

Intratesticular leiomyoma of the body of the testis.

Thomas

Rifkin

1998

Journal of Ultrasound in Medicine

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Leiomyoma of the Vas Deferens

Dougall

Wilson

1969

British Journal of Urology

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TUMOLJRS of the spermatic cord are rare. In the literature available to us we have found reports of only seven leiomyomata of the cord (Portalier, 1908;Lapeyre and O'Daly, 1937; McCook, 1942; Strong, 1942;Zuckner and Aronberg, 1951;Bormel and Young, 1961). In all these cases there was some doubt about the tissue of origin of the tumour, and the following possibilities have been suggested: the smooth muscle of the cremaster (Portalier, 1908), that of the blood vessels in the cord (Bormel and Young, 1961), and that of the vas deferens (Army Registry of Pathology, 1946). The case here reported presents, as we think, convincing evidence of origin from the vas deferens itself. Case History.-A 39-year-old man complained of a lump, present for five years, in relation to his left testis. When first noticed it had been about the size of a small marble. About 15 months before he came to hospital it had become a little painful, and he had noticed that it was a double lump. It did not change in size thereafter, but it did become more painful, and this led him to seek treatment. Examination showed that he had an hour-glassshaped swelling about 4.0 cm. long above his left testis. The lump was neither tender nor fluctuant.At operation the left side of the scrotum was opened and the testis exposed. A solid bi-spherical encapsulated tumour was found, loosely attached to the upper pole of the testis but quite clear of the epididymis. The vas deferens appeared to be adherent to the tumour, but when an attempt was made to dissect the vas off the tumour no plane of cleavage could be found. The vas was therefore divided above and below the tumour and removed in continuity with it. The patient made a straightforward recovery, but defaulted from follow-up after one month.Pathology Report.-The specimen as received was a firm object roughly the shape of an hour glass measuring 4.5 x 2.5 x 2.3 cm. The " waist " was apparently partly encircled by the vas deferens, the vas being about 5.0 cm. long (Fig. 1). Close examination showed that the vas appeared to run through the substance of the mass, not diametrically but quite close to the surface. The cut surface of the tumour closely resembled that of a uterine fibromyoma.Sections were stained by hiematoxylin and eosin, hrematoxylin and Van Gieson, and phosphotungstic acid hrematoxylin (Figs. 2 and 3). Microscopy left no doubt that the lesion was a benign ieiomyofibroma, and also confirmed that the vas deferens did indeed pass through the substance of the neoplasm. In fact, within the tumour the structures of the wall of the vas could no longer be discerned, but on its " line " there were collections of spermatozoa and macrophages, some of which had more than one nucleus.It was concluded that the tumour was truly a leiomyoma which had arisen in the muscle of the vas deferens.Comment.-Thompson (1936) reviewed the literature on tumours of the spermatic cord. He found 216 recorded cases, and added 24 more seen at the Mayo Clinic. Of the 240 cases thus collected about one-third were lipomata, the ...

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Testicular and paratesticular neoplasms in patients 60 years of age and older

Abell

Holtz

1968

Cancer

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Testicular and paratesticular neoplasms from 50 patients 60 years of age or older were assessed with respect to histologic type, clinical findings and outcome. Neoplasms of germ cell origin comprised 24% of the series; there were ten seminomas and two teratocarcinomas. The seminomas were palpable many months before diagnosis and were larger than the other neoplasms. Only two deaths could be attributed to their dissemination. Both teratocarcinomas metastasized and caused death. There were five gonadal stromal neoplasms (10%), one Sertoli cell tumor, three interstitial cell tumors and one undifferentiated stromal tumor. None of the neoplasms recurred or metastasized. Eleven neoplasms (22%) were of supportive tissue or paratesticular origin and six of these arose from muscle—one leiomyoma, two leiomyosarcomas and three rhabdomyo‐sarcomas. The other tumors were two malignant mesotheliomas, one fibroma, one fibrosarcoma and one carcinoma of the epididymis. The lymphoreticular neoplasms were the most common lesion in this series and presented as primary testicular tumors in 22 patients (44%). In five patients asynchronous tumors appeared in the other testes. All but two neoplasms were reticulum cell sarcomas. All patients for whom survival information was available died with disseminated disease.

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Leiomyoma of the Spermatic Cord

Cited by 8 publications

References 2 publications

Intratesticular leiomyoma of the body of the testis.

Intratesticular leiomyoma of the body of the testis.

Leiomyoma of the Vas Deferens

Testicular and paratesticular neoplasms in patients 60 years of age and older

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