Leiomyosarcoma of the spermatic cord: report of two cases and review of the literature

Stein, Avi; Kaplun, A.; Sova, Yanina; Zivan, Ilan; Laver, B; Lurie, Miriam; Lurie, Alan G.

doi:10.1007/bf01836346

Cited by 17 publications

(10 citation statements)

References 8 publications

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“…Tümör belirteçleri sıklıkla normal sınırlar içindedir. Tü-mör boyutları 2-10 cm arasında değişmektedir [11,12]. Fisher ve arkadaşlarının çalışmalarında da 24 LMS olgunun incelenmesi sonrası ortalama tümör çapı 5 cm olarak verilmektedir [13].…”

Section: Discussionunclassified

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: Discussionunclassified

Paratesticular Leiomyosarcoma: A Case Report and Review of the Literature

Erdemır¹

2012

Ann Clin Anal Med

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“…The mass arises from the left spermatic cord. is no side predilection, and patients most often present with an enlarging but painless mass (14).…”

Section: Leiomyosarcomamentioning

confidence: 99%

Multimodality Imaging of Paratesticular Neoplasms and Their Rare Mimics

Akbar¹,

Sayyed²,

Jafri³

et al. 2003

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Extratesticular neoplasms are rare but clinically significant lesions that affect patients of all ages. These neoplasms are generally asymptomatic but may have potentially life-threatening sequelae. Lipoma is the most common primary benign paratesticular neoplasm and the most common tumor of the spermatic cord. Adenomatoid tumor is the most common tumor of the epididymis, followed by leiomyoma. In adult patients, it is imperative to consider sarcomas in the differential diagnosis of all solid tumors of the scrotum. The most common sarcomatous tumors in pediatric patients are embryonal sarcoma and rhabdomyosarcoma. Metastases, particularly from testicular, prostatic, renal, and gastrointestinal primary malignancies, can also occur. Mimics of paratesticular neoplasms including polyorchidism and splenogonadal fusion are rare but must also be considered for optimal management. Ultrasonography (US) is currently the imaging modality of choice. However, US findings are often variable and nonspecific and do not usually allow definitive characterization. Specific computed tomographic and magnetic resonance imaging findings with respect to tumor location, morphologic features, and tissue characteristics can aid in the evaluation of paratesticular neoplasms and help narrow the differential diagnosis.

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“…Primary paratesticular leiomyosarcoma is a rare malignant tumor and there are only occasional descriptions as case reports in the literature [4,5]. Our case is the extremely rare epithelioid subtype of paratesticular leiomyosarcoma.…”

Section: Discussionmentioning

confidence: 64%