Ultrasound appearance of extratesticular myosarcoma

Abstract

High-frequency, real-time ultrasonography has an established role in the evaluation of scrotal masses.' Intratesticular or extratesticular location of masses can be difficult to determine by palpation alone. Sonography can also characterize lesions as fluid filled or solid. Recent studies of nontesticular intrascrotal masses suggest that a homogeneously echogenic sonographic appearance indicates a benign p r o c e~s .~,~ While extratesticular masses, which can arise from the epididymis, spermatic cord, or scrotal tunics, are usually benign,4 our recently encountered case of a pleomorphic myosarcoma is an exception. Its homogeneous echogenicity challenges the reliability of these sonographic criteria to exclude malignancy. CASE REPORTA 46-year-old black male was referred for ultrasound examination to evaluate a right scrotal mass that had been slowly enlarging over a period of one year. It was nontender and nonerythematous. No fever or leukocytosis was present. There was no history of trauma. On physical examination, a hard mass was palpated in the inferior right scrotum. The lesion did not transilluminate. Serum alpha-fetoprotein (AFP) and beta human chorionic gonadotropin were negative. The chest radiograph was normal.Hand-held real-time scrotal sonography, performed with a linear array 5.58-MHz transducer (Acuson-128, Mountain View, California), demonstrated a large, homogeneously echogenic From the

Granulosa Cell Tumor of Scrotal Tunics: A Case Report

“…It was, however, because of the presence of typical large indented nuclei with longitudinal nuclear grooves and Call-Exner bodies, as well as positive immunoreactivity for inhibin, keratin and vimentin, that granulosa cell tumor was diagnosed (13). Fourteen percent of all paratesticular tumors arise from the scrotal tunics and among these, benign fibroma, representing a fibrous reaction to chronic periorchitis, is the most common lesion (14). Although granulosa cell tumor arising from the scrotal tunics has not been previously reported, extratesticular sex-cord stromal tumor in the pelvis has been described (9).…”