Metastasis of primary testicular leiomyosarcoma to the retroperitoneal space

Abstract

A 70-year-old man presented with a left scrotal swelling. A computed tomography scan showed an 8-cm left scrotal mass and no metastasis. Radical orchiectomy with high ligation of the spermatic cord was performed. The tumor was classified as a high-grade leiomyosarcoma of the left testis. An intensive follow-up including repeated computed tomography scans was performed. A computed tomography scan 34 months after the surgery showed a retroperitoneal mass in front of the left kidney. Resection of the mass was performed. Microscopically, the mass was metastatic leiomyosarcoma. Intratesticular leiomyosarcoma is rare; only 18 cases have been reported. This is the first case in which leiomyosarcoma metastasized to the retroperitoneal space postoperatively. We herein review the literature and discuss how intratesticular leiomyosarcoma metastasized to the retroperitoneal space in this patient.

Primary Testicular Leiomyosracoma with Local Recurrence: a Case Report

“…Radiation exposure [3], high-dose anabolic steroid [4] use and chronic inflammation [5] are some of the predicted risk factors [2,6,7]. None of which were associated in our case.…”

“…LMS arise from the smooth muscle cells within the testis such as blood vessels, seminiferous tubules and tunica [8,9]. Primary LMS of the testis presents usually as a painless testicular mass as any other neoplasm of the testis and is managed similarly with inguinal orchidectomy [2,6]. Definitive diagnosis is by histopathological examination and IHC marker study.…”

“…Further adjuvant treatment with radiotherapy and chemotherapy is not standardised due to the limited number of cases reported [2,6]. Most of the cases are considered to have low metastatic potential and limited to testis, and no adjuvant treatment was advised after high inguinal orchidectomy.…”

“…Discussion LMS is the third most common soft tissue sarcoma after malignant fibrous histiocytoma and liposarcoma [1]. Sarcomas of the genitourinary tract account for <5 % of these cases and <2 % of all urological tumours [2]. LMS of the testis are mostly paratesticular with about 100 case reported.…”

“…LMS can arise from any blood vessel, but the pulmonary artery and inferior vena cava are commonest [1]. Male genitourinary LMS are rare, with approximately 100 paratesticular LMS being reported in the literature [2]. Primary intratesticular leiomyosarcoma is even rarer with only 20 cases known so far.…”