Primary intratesticular leiomyosarcoma in a 78-year-old male

Amel Ben Abdallah,Faouzi Mallat,Faouzi Mosbah,Khaled Ben Ahmed,Mouna Ben Othmen,Sarra Mestiri,Sidiyaould Chavey,Wissem Hmida

doi:10.5348/ijcri-2014128-cr-10439

Abstract

Primary leiomyosarcoma of the testis is a rare entity with only less than 20 cases were reported. The standard therapy is difficult to recommend because of the rarity of this tumor. We reported a case of primary intratesticular leiomyosarcoma in a 78-year-old male with unremarkable past medical history. The patient was presented within isolated testicular enlargement. Ultrasound revealed a large solid, homogenous and hyper echoic mass of the right testicle. Lactate dehydrogenase (LDH) was elevated, however, serum alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (-hCG) were with normal limits. A right radical orchidectomy was performed. The diagnosis of primary leiomyosarcoma of testis was confirmed by histopathology. The primary leiomyosarcoma of testis is a rare diagnosis that should be one of the differential diagnoses of testicular mass with normal tumor markers.

Highlights

Primary leiomyosarcoma of the testis is a rare entity with only less than 20 cases were reported
Case Report: We reported a case of primary intratesticular leiomyosarcoma in a 78-year-old male with unremarkable past medical history
The diagnosis of primary leiomyosarcoma of testis was confirmed by histopathology

Summary

Introduction

Leiomyosarcomas are malignant soft-tissue tumors arising from any tissues containing smooth muscles. We report a case of intratesticular leiomyosarcoma in a 78-year-old male who underwent right radical orchiectomy. A 78-year-old male patient was presented with a twoyear history of right scrotal mass. He had no significant past medical history. Scrotal ultrasonographic examination revealed a solid homogenous hyperechoic mass of the right testicle measuring 9x8x8 cm. Computed tomography (CT) scan of the chest, abdomen and pelvis revealed no evidence of metastatic disease or lymphadenopathy. The patient underwent a high ligation of the cord with right radical orchiectomy. Immunohistochemical examination revealed that the tumor cells were strongly positive for calponin, epithelial membrane antigen (EMA) smooth muscle actin and vimentin (Figures 2 and 3) but negative for S-100 and myogenic regulatory protein (MyoD1) proteins. With 24 months of follow-up, which included computed tomography scan of the abdomen, pelvis, bone, and chest, the patient remained free of disease

DISCUSSION

CONCLUSION