Paratesticular sarcomas: two cases with different evolutions

Abstract

SUMMARY Paratesticular sarcomas are rare and account for less than 1% of all adult sarcomas. Intrascrotal tumours can be testicular or paratesticular, paratesticular tumours being rarer (7-10%). Only 30% of paratesticular tumours are malignant and 90% of these are sarcomas. Histological subtypes include leiomyosarcoma, rhabdomyosarcoma, liposarcoma and undifferentiated high-grade pleomorphic sarcoma. Recurrence is frequent in this type of tumour and can occur years from initial diagnosis. These reports show two cases of paratesticular sarcoma with very distinct evolutions. The first case concerns a patient who presented with lowgrade leiomyosarcoma with two local recurrences treated with surgery, and distance recurrence with cutaneous, subcutaneous, pulmonary and hepatic metastasis 30 years after surgery of the primary tumour. The second case reports of a patient who presented with high-grade myxoid liposarcoma with local and distance recurrence 3 years after surgery of the primary tumour, which progressed after chemotherapy; the patient died 7 months after diagnosis of recurrence. BACKGROUND

Paratesticular sarcomas: a case series and literature review

“…8,9 Rhabdomyosarcomas have a propensity to affect males in the first two decades of life and tend to be a more aggressive subtype. 7 Differentiation between the benign and malignant lesions by clinical examination alone is rarely accurate, let alone differentiation of tumour type, 9 thus further characterisation with imaging, namely ultrasonography is required. 10 This is of importance due to the radical nature of the resection in malignant cases (often requiring hemiscrotectomy and high cord ligation) when compared with simple excisions for benign tumours.…”

“…2 The majority of all paratesticular masses are benign and include lipomas, adenomatoid tumours and leiomyomas, however fewer than a third are malignant with 90% of these being sarcomas. 3 Malignant sarcomas include liposarcomas, rhabdosarcomas, and leiomyosarcomas as the most common three variants, with malignant fibrous histiocytomas or dedifferentiated sarcomas also being seen [4][5][6] (see Table 1). The majority of paratesticular sarcomas arise from the spermatic cord.…”

“…The majority of paratesticular sarcomas arise from the spermatic cord. 7 Men in their sixth decade exhibit the peak incidence of paratesticular sarcomas and typically present with a painful or painless scrotal mass or swelling, occasionally accompanied by a hydrocele. 8,9 Rhabdomyosarcomas have a propensity to affect males in the first two decades of life and tend to be a more aggressive subtype.…”

Case Report: Paratesticular Rhabdomyosarcoma

“…On the other hand, paratesticular RMS is rare in adults but often occurs in children, representing 7 to 10% of the tumors in male genitourinary system ( 12 ). Thus, since it’s uncommon in adults, few studies have reported paratesticular eRMS ( 13 , 14 ). Pathologically, the eRMS presents the existence of poorly differentiated cells and rhabdomyoblasts, with abundant eosinophilic cytoplasm indicating embryonal rhabdomyosarcoma.…”

Paratesticular Tumors: A Report of Two Rare Cases

“…Paratesticular tumors are rare comprising 7-10% of total intrascrotal tumors of which 70% are benign and 30% are malignant. [1] Leiomyoma and undifferentiated pleomorphic sarcoma are two such rare tumors which should be accurately diagnosed for purpose of treatment and prognosis. Scrotal leiomyomas are essentially benign arising from the subcutaneous tissue or dartos muscle.…”