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Cancer metastasis is a disease of extreme clinical relevance, as it is responsible for more than 90% of cancer-associated mortality. The molecular mechanism and critical regulators involved in this complex multi-stage process of metastasis is poorly deciphered in soft tissue sarcomas (STS), a heterogeneous group of rare tumors with high metastatic potential. Therefore, we aimed at identifying miRNA and transcription factor (TF) regulatory networks and paths in STS metastasis. We integrated mRNA and miRNA expression profiles with curated regulations (TF→gene, TF→miRNA, miRNA→gene) from different databases and constructed a potentially active regulatory sub-network in STS metastasis. From functional and topological analysis, we found nine novel regulators of Notch signaling sub-network which are conjectured to play critical role in metastasis of STS. This illustrated that the sub-network is promising for identification of critical regulators. Further analysis deploying our developed tool ‘RiNAcyc’ and computing coverage ratio of known STS associated genes and miRNAs identified a 15 node active path. This potential path highlights the crucial role of BMP2, hsa-miR-24, AP2 and MYC as the up-stream regulators of the path and hsa-miR-215 and TYMS as potential indicator of chemotherapeutic benefit in STS metastasis.

A 27-year-old male presented with a gradually increasing left scrotal mass. There was no significant past medical history. Ultrasonography of the left scrotum showed a hypoechoic, intratesticular mass with solid and cystic components. Laboratory investigations revealed normal serum levels of alpha-fetoprotein, beta human chorionic gonadotropin and lactate dehydrogenase. He underwent left high inguinal orchidectomy due to suspicion of testicular malignancy. After histopathologic examination and immunostaining, a diagnosis of high-grade primary testicular leimyosarcoma was ascertained. Only a few cases of primary intratesticular leiomyosarcoma have been reported in literature with the mean age of presentation of 50 years. In younger individuals, these tumors have been reported in a setting of predisposing factors like anabolic steroid use, testicular germ cell tumors, chronic inflammation of testis and testicular field radiation for treatment of leukemia. We present a case of high grade leiomyosarcoma of testis in a young male without any known predisposing factors.Keywords: Immunohistochemistry; leiomyosarcoma; sarcoma; testis. ÖZYirmi yedi yaşında bir erkek giderek artan sol skrotal kitle ile geldi. Tıbbi öyküsünde önemli bir özellik yoktu. Sol skrotal ultrason testis içinde solid ve kistik özellikleri olan bir kitleyi gösterdi. Laboratuvar araştırmaları serum alfa fetoprotein, beta human koriyonik gonadotropin ve laktat dehidrogenazın normal seviyelerde olduğunu ortaya çıkardı. Testis malinitesi kuşkusuyla sol yüksek orşiyektomi uygulandı. Histopatolojik inceleme ve immün boyamadan sonra yüksek dereceli primer testis leyomiyosarkom tanısı konuldu. Literatürde yaş ortalaması 50 olan az sayıda primer intratestiküler leyomiyosarkom bildirilmiştir. Anabolik steroid kullanımı, testisin germ hücreli tümörleri, testis inflamasyonu ve lösemi için testise radyasyon gibi predispozan faktörlerinin var olduğu durumlarda daha genç kişilerde de raporlanmıştır. Bilinen predispozan faktörleri olmayan genç bir erkekte yüksek dereceli bir leyomiyosarkom olgusunu sunuyoruz.Anahtar Kelimeler: İmmünohistokimya; leyomiyosarkom; testis.Cite this article as: Siraj F, Sharma S, Rai CB, Vasudeva P. Primary high grade testicular leiomyosarcoma: A rare malignancy in a young male. Turk

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