Dedifferentiated Liposarcoma in the Spermatic Cord Finally Diagnosed at 7th Resection of Recurrence: A Case Report and Bibliographic Consideration

Morozumi, Kunio; Kawasaki, Yoshihide; Kaiho, Yasuhiro; Kawamorita, Naoki; Fujishima, Fumiyoshi; Watanabe, Mika; Arai, Yoichi

doi:10.1159/000479364

Cited by 8 publications

(7 citation statements)

References 5 publications

(5 reference statements)

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“…The time to dedifferentiation is 2-25 years (12). The distant metastasis rate for PDDLPS is 5%-10% higher than that for PWDLPS (1,11,13) (Table 1). Therefore, the prognosis is also worse for PDDLPS than for PWDLPS (10).…”

Section: Discussionmentioning

confidence: 96%

Case report: Paratesticular dedifferentiated liposarcoma with poor prognosis

2022

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Background/AimMost paratesticular liposarcomas (PLPSs) are well-differentiated liposarcomas (WDLPSs) with favourable prognoses. As such, the rare occurrence of PLPS often leads to its misdiagnosis as a hernia or hydrocele on physical examination. Curative resection of the tumour may not be possible in cases where PLPSs have transformed into dedifferentiated liposarcomas (DDLPSs) owing to a delay in diagnosis. Herein, we describe a case of unresectable paratesticular dedifferentiated liposarcoma (PDDLPS) with poor prognosis due to delayed diagnosis.Case ReportA 57-year-old man visited our hospital with a chief complaint of a right scrotal mass, which was diagnosed as scrotal hydrocele but without treatment or follow-up. Eight years later, the patient complained of abdominal distension, and a computed tomography scan revealed the presence of retroperitoneal and right scrotal masses. The right scrotal mass was removed, and histopathology revealed DDLPS. The patient was diagnosed with unresectable PDDLPS metastasising to the retroperitoneum, and the left pleura was treated with doxorubicin. After an initial response, pleural effusion and ascites increased during the sixth cycle of chemotherapy. The patient subsequently received eribulin but died 5 months after the initial DDLPS diagnosis.ConclusionIt is difficult to distinguish PLPS from benign inguinal hernia and hydrocele testis on physical examination. PLPS generally has a considerably good prognosis. However, failure to diagnose WDLPS can be dangerous as it might lead to malignant transformation to DDLPS, which has a poor prognosis. Physicians should consider this malignancy when examining patients with hernias or hydroceles of the inguinal region and should perform ultrasonography or magnetic resonance imaging.

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Section: Discussionmentioning

confidence: 96%

Case report: Paratesticular dedifferentiated liposarcoma with poor prognosis

2022

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“…A wide and complete resection with negative microscopic margins is crucial for treatment of this tumor but no always easy to obtain [9]. Therefore, adjuvant therapy such as RT or CHT could be considered.…”

Section: Discussionmentioning

confidence: 99%

Adjuvant radiotherapy in recurrent pleomorphic leiomyosarcoma of spermatic cord: A case report and literature review

Solazzo¹,

Caivano²,

Benevento³

et al. 2021

J Clin Images Med Case Rep

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Pleomorphic leiomyosarcoma of spermatic cord is a very rare urologic disease, so there are no clear guidelines. The mainstay of treatment is surgery with wide excision margins. The role of adjuvant treatments, such as Chemotherapy (CHT) or Radiotherapy (RT), is not clear, due to the few data available in the literature. However, adjuvant treatments could be considered in patients with a high risk of local recurrence: R1 status after surgery and highgrade histology. We report the case of 68-year old man affected by recurrent pleomorphic leiomyosarcoma of spermatic cord right, who, in five years, underwent many surgical treatments for local recurrence, and also adjuvant CHT. The last surgery shows positive margins. Therefore, the patient receive adjuvant RT on the surgical bed and right inguinal nodes with a dose of 54 Gy in 27 fractions and VMAT technique. The treatment was well tolerated, the follow-up at 12 months is negative for local recurrence and show absence of toxicity. However a long-term follow-up is necessary to confirm the efficacy of radiotherapy on outcomes and especially on local control. Keywords: pleomorphic leiomyosarcoma; recurrence; positive margins; adjuvant radiotherapy

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“…Nevertheless, as mentioned before, the spermatic cord liposarcoma is an infrequent pathology and represents an atypical location for sarcomas, reason why there is not enough data to establish the guidelines for adequate management. The clinical presentation could be frequently confused with an unspecific volume increase, inguinal hernias, recurrence of inguinal hernias, lipomas or another kind of tumors [12][13][14][15]. The experience in the management is extrapolated from the treatment of retroperitoneal tumors, case series, case reports and expert's opinions.…”

Section: Discussionmentioning

confidence: 99%

Spermatic Cord Liposarcoma in the Context of a Recurrent Inguinal Hernia, Case Report

Ignacio¹,

Enrique²,

Irene³

et al. 2018

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Introduction: The spermatic cord sarcomas are rare entities, with only 46 cases reported in the last 5 years worldwide. The majority of those were misdiagnosed as inguinal hernias and treated with hernioplasty, delaying the correct treatment. Case report: We present a 56-year-old male who was operated 3 times for right inguinal hernia recurrence. Because of a persistent right spermatic cord bulk, he had a right radical orchiectomy, and the pathology reported the diagnosis of liposarcoma. Afterward, we requested a PET/CT which revealed a hypermetabolic lesion of 33x32mm in the right scrotum. We performed an oncological resection and classified the tumor as a stage III liposarcoma. Conclusion: The reported case illustrates the classical presentation of these tumors and their evolution. Despite the radical treatment, due to the biology of this cancer, the prognosis is bad if patients are not operated properly from the beginning.

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Dedifferentiated Liposarcoma in the Spermatic Cord Finally Diagnosed at 7th Resection of Recurrence: A Case Report and Bibliographic Consideration

Cited by 8 publications

References 5 publications

Case report: Paratesticular dedifferentiated liposarcoma with poor prognosis

Case report: Paratesticular dedifferentiated liposarcoma with poor prognosis

Adjuvant radiotherapy in recurrent pleomorphic leiomyosarcoma of spermatic cord: A case report and literature review

Spermatic Cord Liposarcoma in the Context of a Recurrent Inguinal Hernia, Case Report

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