Non–Germ Cell Intrascrotal Tumors in Adults: A Retrospective Cohort of Localized and Metastatic Disease From a Tertiary Cancer Center

Abstract

Purpose: Given their rarity, little is known about outcomes and optimal treatment strategies for non–germ cell intrascrotal tumors (NGCITs). Here, we report a retrospective cohort of NGCITs and describe clinicopathological features and treatment patterns and outcomes. Materials and Methods: Patients 18 years or older with a histological diagnosis of NGCIT were eligible. Electronic health records were reviewed to assess clinical features, disease characteristics, and outcomes. Radiological responses were determined by RECIST 1.1. Time-to-event outcomes were estimated using the Kaplan-Meier method and compared through the log-rank test and Cox univariate regression. Results: From January 2009 to April 2022, 896 patients were reviewed for eligibility, with 36 patients with NGCIT identified. At diagnosis, 29 were nonmetastatic (Leydig tumors, n = 9; sarcomas, n = 8; Sertoli tumors, n = 3; others, n = 9) and 7 were metastatic (sarcomas, n = 5; others, n = 2). Five patients (sarcomas, n = 2; Leydig tumors, n = 2; mesothelioma, n = 1) developed metastatic disease after a median follow-up of 18.6 months. Systemic treatment (n = 10) was given according to primary histology, with partial responses observed in 2 patients with metastatic rhabdomyosarcoma treated with VAC regimen (vincristin, adriamycin, and cyclophosphamide). Overall survival varied according to disease classification (benign vs malignant, hazard ratio [HR] 4.5, confidence interval [CI] 95% 1.0-21.2) or presentation (all patients: metastatic vs localized at diagnosis, HR 7.1, CI 95% 2.0-24.5; patients with malignant disease: metastatic vs localized at diagnosis, HR 5.0, CI 95% 1.1-24.4). Conclusions: NGCITs comprise a heterogeneous group of diseases, with a relatively better prognosis at early stages. Most metastatic cases occurred within patients with paratesticular sarcomas and mesotheliomas.