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Agarwal S, Bains L, Makthala S, Lal P, Singh M. An inguinal enigma: Myxoid liposarcoma in a female. Clin Case Rep 2023; 11:e7209. [PMID: 37091969 PMCID: PMC10114096 DOI: 10.1002/ccr3.7209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/19/2023] [Accepted: 03/29/2023] [Indexed: 04/25/2023] Open
Abstract
Myxoid liposarcoma of the inguinal region is rare, can mimics an inguinal hernia. Any swelling in the inguinal region, that is partially reducible, fluctuant, soft, and without any signs of bowel obstruction should be evaluated further.
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Affiliation(s)
- Shantanu Agarwal
- Department of General SurgeryMaulana Azad Medical CollegeNew DelhiIndia
| | - Lovenish Bains
- Department of General SurgeryMaulana Azad Medical CollegeNew DelhiIndia
| | - Sripooja Makthala
- Department of General SurgeryMaulana Azad Medical CollegeNew DelhiIndia
| | - Pawan Lal
- Department of General SurgeryMaulana Azad Medical CollegeNew DelhiIndia
| | - Meeta Singh
- Department of PathologyMaulana Azad Medical CollegeNew DelhiIndia
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Caviglia A, Beverini M, Pacchetti A, Branger N, Pignot G, Bertucci F, Walz J. A Giant Paratesticular Liposarcoma: Case Report and Literature Review. Case Rep Oncol 2023; 16:162-166. [PMID: 36970715 PMCID: PMC10035545 DOI: 10.1159/000528221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/02/2022] [Indexed: 03/25/2023] Open
Abstract
Liposarcoma of the spermatic cord (LSC) is a very rare disease. In literature, are reported less than 350 cases. Genitourinary sarcomas account for <5% of all soft-tissue sarcomas and <2% of malignant urologic tumours. An inguinal mass is the clinical presentation, which can mimic a hernia or hydrocele. Since it is such a rare disease, there are insufficient data on chemotherapy and radiotherapy, and in any case, the data come from low-level scientific evidence. Here, we report the case of a patient who came to the observation for a giant inguinal mass, in which a definitive diagnosis was obtained with the histological examination.
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Affiliation(s)
- Alberto Caviglia
- Department of Urology, Institut Paoli-Calmettes, Marseille, France
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Martina Beverini
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Department of Urology, UMC+, Maastricht, The Netherlands
| | | | - Nicolas Branger
- Department of Urology, Institut Paoli-Calmettes, Marseille, France
| | - Geraldine Pignot
- Department of Urology, Institut Paoli-Calmettes, Marseille, France
| | | | - Jochen Walz
- Department of Urology, Institut Paoli-Calmettes, Marseille, France
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Pikramenos K, Katsimperis S, Zachou M, Giannakakou M, Mitsogianni M, Mitsogiannis I. Liposarcoma of the Spermatic Cord Mimicking an Inguinal Hernia: A Case Report and Literature Review. Cureus 2022; 14:e28269. [PMID: 36158429 PMCID: PMC9491821 DOI: 10.7759/cureus.28269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 11/06/2022] Open
Abstract
Liposarcomas of the spermatic cord are extremely rare, with less than 200 cases in the literature. We present a case of sclerosing mixed with myxoid liposarcoma of the left spermatic cord in a 55-year-old male patient, mimicking an inguinal hernia on pre-operative ultrasound. The patient underwent orchidectomy and is currently on follow-up surveillance with no signs of recurrence.
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Inadvertent Inguinal Sarcoma Excision during Hernia Surgery: Outcomes, Gender Analysis, and Prevention. Int J Surg Oncol 2020; 2020:8374790. [PMID: 33489372 PMCID: PMC7787872 DOI: 10.1155/2020/8374790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 11/17/2020] [Accepted: 11/24/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction Inadvertent excision of a soft tissue sarcoma during hernia surgery is a preventable clinical scenario that leads to unnecessary patient morbidity. Prior series are few, which only include male patients with little focus on prevention. The purpose of this study is to report the presenting features and outcomes of both male and female patients who underwent inadvertent inguinal sarcoma excision during hernia surgery. Methods A retrospective analysis of a single sarcoma referral center identified 33 patients who were referred for definitive treatment. Patients were divided into three clinically relevant groups based on intraoperative diagnosis, sex, and location of the mass relative to the inguinal ligament. T-tests and Fisher's exact tests were performed to compare continuous and categorical variables, respectively. Kaplan–Meier modeling was performed to assess sarcoma-specific survival. Results Females were younger (47 years vs. 61 years, p=0.003) and had smaller sarcomas (6.7 cm vs. 11 cm, p=0.012) compared to males. Only two sarcomas (2/33, 6%) were <4 cm in size. The majority of sarcomas in females were above the inguinal ligament (12/14, 86%). Twenty-nine (88%) underwent definitive R0 excision. The mean number of surgeries per patient was three (range 1–13), with nineteen (58%) patients requiring flap reconstruction and six (18%) requiring vascular bypass. Five patients locally recurred (15%) at a mean of 38 months after definitive excision (range 5–128 months). Overall sarcoma-specific disease-free survival was 64%, with no difference between males (80 ± 11%) and females (59 ± 17%) (p=0.885). Mean follow-up was 75 months (range 5–212). Conclusion This is the second largest study regarding inadvertent inguinal sarcoma excision and the first to include females. When a suspected hernia is >4 cm, irreducible, firm, and is growing, especially in females, consider obtaining preoperative advanced three-dimensional imaging (CT or MRI) that can differentiate a neoplasm from a hernia.
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Bhullar JS, Mohey L, Chaudhary S, Herschman B, Ferguson L. Liposarcoma of the Spermatic Cord: An Unexpected Finding of Inguinal Hernia Repair. Am Surg 2020. [DOI: 10.1177/000313481307900514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Leela Mohey
- Department of Surgery Providence Hospital and Medical Centers Southfield, Michigan
| | - Sushant Chaudhary
- Department of Surgery Providence Hospital and Medical Centers Southfield, Michigan
| | - Barry Herschman
- Department of Surgery Providence Hospital and Medical Centers Southfield, Michigan
| | - Lorenzo Ferguson
- Department of Surgery Providence Hospital and Medical Centers Southfield, Michigan
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Khan WF, Rathore YS, Aduri RS, Mridha AR. Lipoleiomyosarcoma of spermatic cord: an unusual presentation. BMJ Case Rep 2019; 12:12/8/e228952. [PMID: 31383673 DOI: 10.1136/bcr-2018-228952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Spermatic cord malignancies are very rare tumours. Less than 100 cases of cord liposarcoma have been reported in the literature. Divergent differentiation into leiomyosarcoma and liposarcoma is a rare phenomenon but can occur. Lipoleiomyosarcoma usually represents the well-differentiated subtype of this entity. We report such a rare case in spermatic cord with an unusual presentation as a recurrent inguinal hernia in a 62-year-old man.
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Affiliation(s)
- Washim Firoz Khan
- Surgical Discipline, All India Institute of Medical Sciences, New Delhi, India
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Ochi A, Toki S, Vanichakarn D, Suzuki K, Kitagawa Y, Abe H. Laparoscopic-assisted surgery for liposarcoma of the spermatic cord extending to the retroperitoneal cavity through the internal inguinal ring. IJU Case Rep 2019; 2:253-256. [PMID: 32743428 PMCID: PMC7292137 DOI: 10.1002/iju5.12084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 05/08/2019] [Indexed: 12/19/2022] Open
Abstract
Introduction Liposarcoma of the spermatic cord is a rare disease, reportedly treated with radical high orchiectomy. However, laparoscopic-assisted surgery for spermatic cord liposarcoma extending to the retroperitoneal cavity through the internal inguinal ring has not yet been reported. Case presentation A 78-year-old man had a spermatic cord tumor that extended to the retroperitoneal cavity through the internal inguinal ring and invaded the abdominal wall muscles. We performed laparoscopic-assisted surgery and successfully separated the tumor from the contiguous organs and vessels. The tumor was resected en bloc with abdominal wall muscles, and a muscular defect was repaired with a left tensor fascia lata muscle flap. Pathological analysis revealed a well-differentiated liposarcoma with negative surgical margins. There was no recurrence at 1 year post-surgery. Conclusion Laparoscopic-assisted surgery is a feasible and minimally invasive procedure for treating liposarcoma of the spermatic cord extending to the retroperitoneal cavity through the internal inguinal ring.
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Affiliation(s)
- Atsuhiko Ochi
- Department of Urology Kameda Medical Center Kamogawa Chiba Japan
| | - Sari Toki
- Department of Urology Kameda Medical Center Kamogawa Chiba Japan
| | | | - Koichiro Suzuki
- Department of Urology Kameda Medical Center Kamogawa Chiba Japan
| | - Yasuhide Kitagawa
- Department of Urology Komatsu Municipal Hospital Komatsu Ishikawa Japan
| | - Hirokazu Abe
- Department of Urology Kameda Medical Center Kamogawa Chiba Japan
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Ando T, Nakayama R, Mizusawa T, Sakai T, Otsuka H, Katagiri A. Dedifferentiated spermatic cord liposarcoma with macroscopic ossification. IJU Case Rep 2018; 1:5-8. [PMID: 32743353 PMCID: PMC7292200 DOI: 10.1002/iju5.12017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 07/16/2018] [Indexed: 11/18/2022] Open
Abstract
Introduction Liposarcoma is a malignant neoplasm of the adipose tissue, and dedifferentiated liposarcoma is a relatively rare subtype. Liposarcomas are typically located in the lower extremities or retroperitoneum, but dedifferentiated liposarcoma of the spermatic cord is rare and no case of it with macroscopic ossification has been reported in the literature. Case presentation A male presented to our hospital with a painful, palpable, and hard left suprapubic mass, formed over 3 months. The mass was diagnosed as a spermatic cord tumor and was resected using high orchiectomy. Due to the histological diagnosis of dedifferentiated spermatic cord liposarcoma with ossification and positive margins, a second extended resection and adjuvant radiotherapy were performed. Conclusion To differentiate spermatic cord liposarcoma preoperatively is difficult. There is no gold standard treatment for it, although surgical complete resection with clear microscopic margins would be the most effective treatment.
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Affiliation(s)
- Takashi Ando
- Department of Urology Niigata Prefectural Central Hospital Jouetsu, Niigata Japan
| | - Ryo Nakayama
- Department of Urology Niigata Prefectural Central Hospital Jouetsu, Niigata Japan
| | - Takaki Mizusawa
- Department of Urology Niigata Prefectural Central Hospital Jouetsu, Niigata Japan
| | - Takeshi Sakai
- Department of Pathology Niigata Prefectural Central Hospital Jouetsu, Niigata Japan
| | - Hiroshi Otsuka
- Department of Orthopedic Surgery Niigata Prefectural Central Hospital Jouetsu, Niigata Japan
| | - Akiyoshi Katagiri
- Department of Urology Niigata Prefectural Central Hospital Jouetsu, Niigata Japan
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Abstract
PURPOSE OF REVIEW Spermatic cord tumors (SCT) are very rare. The present review discusses the most recent literature regarding clinical presentation, pathological characteristics, diagnosis, and management of SCT. RECENT FINDINGS Although the majority of SCT are benign, when malignant almost all SCT are sarcomas. Liposarcomas are the most common; whereas rhabdomyosarcomas recorded the highest tendency of develop distant metastases. The clinical presentation is usually a unilateral solid slow-growing mass at the level of the inguinal canal and of the scrotum. Surgical excision represents the most common used treatment, and considering the risk in developing local recurrence, radical inguinal orchiectomy and resection of the tumor with negative microscopic surgical margins is mandatory. Adjuvant therapies such as radiotherapy and chemotherapy have been suggested in selected patients, but clear data to demonstrate any improvement in survival are not available. SUMMARY SCT are rare tumors with high risk of misdiagnosis or mistreatment. The majority are benign, but when malignant almost all are sarcomas. A surgical excision is the treatment of choice; however, no clear data exists documenting the efficacy of a multimodal treatment in reducing high local recurrence rates after surgery.
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Noh D, Choi W, Son W, Lee M, Park S, Lee K. Liposarcoma of the spermatic cord in a Toy Poodle. J Vet Med Sci 2017; 79:2026-2029. [PMID: 29142149 PMCID: PMC5745184 DOI: 10.1292/jvms.17-0357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Liposarcoma of the spermatic cord is extremely rare in dogs and humans. This report describes the clinical signs, typical diagnostic imaging including ultrasound and computed tomography, and treatment of a liposarcoma of the spermatic cord of a Toy Poodle confirmed by histological examination after a surgical procedure. This case highlights the importance of preoperative diagnostic imaging and histopathological examination in dogs with an inguinal or scrotal mass.
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Affiliation(s)
- Daji Noh
- College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Korea
| | - Wooson Choi
- Two Man Veterinary Hospital, Daegu 42770, Korea
| | - Woochan Son
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Manhee Lee
- College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Korea
| | - Seungchun Park
- College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Korea
| | - Kija Lee
- College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Korea
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Rare Case of a Well-Differentiated Paratesticular Sarcoma of the Spermatic Cord in a 60-Year-Old Patient. Case Rep Urol 2017; 2017:7903242. [PMID: 28352488 PMCID: PMC5352881 DOI: 10.1155/2017/7903242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 12/29/2016] [Indexed: 11/17/2022] Open
Abstract
Introduction. Liposarcomas are tumors that occur mostly in the retroperitoneum. Of all liposarcomas only 3 to 7% are found in the paratesticular region. The spermatic cord is the main site of origin in these cases. The patients ages range from 50 to 60 years. This malignant disease can result in a loss of fertility aside from life-threatening sequelae. Case. We present a case of a liposarcoma of the paratesticular region. A 60-year-old man was referred with a painless mass in the scrotum and the right inguinal region. The patient underwent surgery and the mass was removed along with the right testis, the spermatic cord, and the soft tissues to the internal inguinal ring. Histopathological examination found a well-differentiated liposarcoma of 80⁎80 mm. The surgical margins were negative. The adjuvant treatment consisted in radiation therapy of the right inguinoscrotal area to the dose of 54 Gray, 2 Gy per session, 5 times a week. Conclusion. Paratesticular liposarcomas are rare tumors. Surgery with large margin resections was the main treatment in all reported cases. The adjuvant treatment is still unclear especially when the surgical margins are negative. The main factor that indicated this adjuvant treatment was the size of the tumor and the histologic subtype.
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Chalouhy C, Ruck JM, Moukarzel M, Jourdi R, Dagher N, Philosophe B. Current management of liposarcoma of the spermatic cord: A case report and review of the literature. Mol Clin Oncol 2017; 6:438-440. [PMID: 28451429 DOI: 10.3892/mco.2017.1157] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 12/12/2016] [Indexed: 11/06/2022] Open
Abstract
Liposarcomas of the spermatic cord, a rare cause of an inguinal mass, may closely mimic inguinal hernias on clinical examination. However, these tumors require a different surgical approach and treatment plan; therefore, intraoperative diagnosis might complicate patient management. We report the case of a 63-year-old man who presented with a mobile mass in the inguinal canal consistent with an inguinal hernia. The patient was subsequently diagnosed with a liposarcoma of the spermatic cord and successfully treated with extensive local resection, including radical orchiectomy and en bloc resection of the mass and associated cord structures. No adjuvant therapy was deemed necessary, and the patient remained asymptomatic and disease-free 10 years after surgery. The details of this case are presented, along with a review and discussion of the currently available data regarding the diagnosis and management of this challenging condition.
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Affiliation(s)
- Charbel Chalouhy
- Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Jessica M Ruck
- Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Maroun Moukarzel
- Department of Urology, Hôtel Dieu de France Hospital, Beirut, Lebanon
| | - Roy Jourdi
- Department of Urology, Hôtel Dieu de France Hospital, Beirut, Lebanon
| | - Nabil Dagher
- Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA
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Gregorio MD, D'Hondt L, Lorge F, Nollevaux MC. Liposarcoma of the Spermatic Cord: An Infrequent Pathology. Case Rep Oncol 2017; 10:136-142. [PMID: 28203177 PMCID: PMC5301103 DOI: 10.1159/000455900] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 01/06/2017] [Indexed: 12/19/2022] Open
Abstract
Objective To describe a rare pathology, the liposarcoma of the spermatic cord (LSC), and discuss its diagnosis and treatment. Materials and Methods We report a case of well-differentiated LSC in a 61-year-old man. The main complaint was painless enlargement in the right inguinoscrotal area that appeared 6 months prior to presentation. Ultrasonography showed a heterogeneous and hyperechogenic mass of the right spermatic cord that was highly suspicious of malignancy. Computed tomography confirmed a heterogeneous supratesticular mass. The mass was surgically removed. Results Pathological examination showed a well-differentiated LSC. The patient did not receive any additional treatment. The follow-up did not present complications or further symptoms and, at present, the patient is in complete remission. Conclusion LCSs are a very rare entity. The diagnosis is difficult and often mistaken with common scrotal swelling associated with a hernia, hydrocele, or other tumour. Treatment should include complete surgical excision, usually by radical inguinal orchiectomy. A long follow-up period is necessary.
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Paratesticular Sarcoma: Typical Presentation, Imaging Features, and Clinical Challenges. Urology 2016; 100:163-168. [PMID: 27639792 DOI: 10.1016/j.urology.2016.09.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 08/29/2016] [Accepted: 09/03/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To describe the major imaging features, together with clinical data, of paratesticular sarcomas. MATERIALS AND METHODS A retrospective analysis was performed of available imaging and clinical data of 77 consecutive cases of paratesticular sarcoma referred to the soft tissue sarcoma center at the Royal Marsden hospital between January 2006 and January 2015. RESULTS Of the total cases, 87% had been referred postoperatively, 43% of which had been imaged preoperatively and 24% of which required re-resection due to incomplete initial excision. On imaging, abnormal fat was present in 73% of paratesticular liposarcomas, with solid or enhancing components indicating high-grade tumors. Leiomyosarcomas and rhabdomyosarcomas were all purely solid masses. CONCLUSION Paratesticular sarcomas are rare, and lack of awareness may compromise treatment and outcome. They may be mistaken for common clinical problems such as inguinal hernias and epididymal cysts. Surgery for these presumed diagnoses may result in inadequate clearance and an increased risk of recurrence. A low threshold for imaging atypical paratesticular masses is needed, as this may better inform management.
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Cao MX, Chen J, Zhang JL, Wei X, Liang YY. Organ-sparing Surgery in Treating Patients with Liposarcoma of the Spermatic Cord: Institutional Experience and Pooled Analysis. Asian Pac J Cancer Prev 2016; 16:3419-23. [PMID: 25921155 DOI: 10.7314/apjcp.2015.16.8.3419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Liposarcoma of the spermatic cord is rare and frequently misdiagnosed. The standard therapeutic approach has been radical inguinal orchiectomy with wide local resection of surrounding soft tissues. The current trend of organ preservation in the treatment of several cancers has started to evolve. Herein we present our testis-sparing surgery experience in the treatment of spermatic cord liposarcoma and a pooled analysis on this topic. MATERIALS AND METHODS Clinical information from patient receiving organ-sparing surgery was described. Clinical studies evaluating this issue were identified by using a predefined search strategy, e.g., Pubmed database with no restriction on date of published papers. The literature search used the following terms: epidemiology , surgery , chemotherapy , radiotherapy , testis sparing surgery, spermatic cord sarcomas/ liposarcomas. RESULTS Patient received a complete excision of the lesion, preserving the spermatic cord and the testis. The final pathological report showed a well differentiated liposarcoma with negative surgical margins and no signs of local invasion. After 2-year of follow-up, there was no evidence of local recurrence. Since the first case reported in 1952, a total of about 200 well-documented spermatic cord liposarcoma cases have been published in English literature. Among these patients, only three instances were reported to have received an organ-sparing surgery in the treatment of spermatic cord liposarcoma. CONCLUSIONS Radical inguinal orchiectomy and resection of the tumor with a negative microscopic margin is the recommended treatment for liposarcoma of the spermatic cord. But for small, especially well-differentiated, lesions, testis-sparing surgery might be a good option if an adequate negative surgical margin is assured.
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Affiliation(s)
- Ming-Xin Cao
- Department of Urology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China E-mail :
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Palomeque Jiménez A, Reyes Moreno M, Martín Cano J, Calzado Baeza S. Fibrohistiocitoma maligno del cordón espermático. UROLOGÍA COLOMBIANA 2015. [DOI: 10.1016/j.uroco.2015.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Liposarcoma of the spermatic cord masquerading as an inguinal hernia. Case Rep Med 2014; 2014:735380. [PMID: 24592281 PMCID: PMC3926318 DOI: 10.1155/2014/735380] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 11/08/2013] [Accepted: 11/21/2013] [Indexed: 02/01/2023] Open
Abstract
This is a case of a 70-year-old male who presented with a mass in his right testicle. He was treated with antibiotics for epididymitis while undergoing serial ultrasounds for one year due to testicular swelling and pain. His fourth ultrasound revealed a mild hydrocele with a large paratesticular mass of undescribed size, superior to the right testicle, thought to be an inguinal hernia. Preoperative CT scan demonstrated a large fat-containing inguinal hernia extending into the scrotal sac. An inguinal hernia repair was complicated by fatty tissue surrounding the testicle requiring a right orchiectomy. Pathology review of the tissue demonstrated well-differentiated liposarcoma with a small focus of dedifferentiation grade 2 tumor. Tumor was identified at the inked margins indicating an incomplete resection. It was decided that no further surgical intervention was needed and the patient would undergo surveillance for local tumor recurrence. Six-month follow-up MRI scan was negative for any recurrence of disease. A liposarcoma presenting as a paratesticular mass with spermatic cord involvement is rare, and imaging studies may fail to distinguish a liposarcoma from normal adipose tissue.
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Govardhane P, Zafar FA, Geelani IA, Girish H, Sharma D, Rajagopal V, Swain M, Swarnalatha G. Liposarcoma of spermatic cord – A rare entity. APOLLO MEDICINE 2013. [DOI: 10.1016/j.apme.2013.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Li F, Tian R, Yin C, Dai X, Wang H, Xu N, Guo K. Liposarcoma of the spermatic cord mimicking a left inguinal hernia: a case report and literature review. World J Surg Oncol 2013; 11:18. [PMID: 23351168 PMCID: PMC3585812 DOI: 10.1186/1477-7819-11-18] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Accepted: 01/14/2013] [Indexed: 11/17/2022] Open
Abstract
Liposarcoma of the spermatic cord (LSC) is a rare condition characterized by a painless inguinal or scrotal mass. To our knowledge, only about 200 cases have been previously reported in the literature. These tumors are often mistaken for common scrotal swellings, such as hydroceles and hernias. We present a LSC case in which a definitive diagnosis was obtained upon histological examination. We also provide a literature review of other cases that have been reported.
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Affiliation(s)
- Fubiao Li
- Department of Andrology, First Hospital of Jilin University, Changchun, Jilin, China
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Abstract
Primary spermatic cord tumors are rare yet clinically significant urologic lesions that affect patients of all ages. They are the most common tumors of the paratesticular region and generally present as asymptomatic, slow growing, firm, palpable paratesticular masses. Although most of them are benign comprised primarily of lipomas, approximately 25% are potentially life-threatening malignant tumors. The most common reported malignant histological types include liposarcomas, leiomyosarcomas, rhabdomyosarcomas, malignant fibrous histiocytoma, and fibrosarcomas. Management of these malignant tumors has been difficult because of their rarity, therefore there is little consensus regarding optimal surgical and adjunctive treatment strategies. It is recommended that radiological techniques such as scrotal ultrasound (US), computed tomography, and magnetic resonance be used to evaluate these masses before surgery. The curative treatment of choice is radical orchiectomy with high cord ligation and wide excision of surrounding soft tissue structures within the inguinal canal. Patients with inadequately resected disease should undergo a reoperative procedure for wide inguinal re-resection. Retroperitoneal lymphadenectomy is recommended when there is preoperative evidence of retroperitoneal lymph node metastasis and as an adjuvant treatment for rhabdomyosarcomas since they have a higher propensity for lymphatic spread. Adjuvant treatments, such as radiotherapy and chemotherapy, have shown little efficacy, except in the management of patients with local recurrence or high-grade rhabdomyosarcomas. Long-term follow up is recommended given their high recurrence rates.
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Rais G, Andaloussi MB, Raissouni S, Barki A, Allaoui M, Zouaidia F, Afif M, Mrabti H, Errihani H. [Dedifferentiated liposarcoma of the spermatic cord: therapeutic difficulties of large tumors]. Pan Afr Med J 2011; 8:49. [PMID: 22121456 PMCID: PMC3221406 DOI: 10.4314/pamj.v8i1.71167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Accepted: 04/26/2011] [Indexed: 11/17/2022] Open
Affiliation(s)
- Ghizlane Rais
- Service d'oncologie médicale, Institut National d'oncologie, Rabat, Morocco
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