Paratesticular Leiomyosarcoma Research Articles

Paratesticular leiomyosarcoma in an elderly man

Soft tissue tumors, both benign and malignant, of the testes are relatively uncommon. Primary leiomyosarcoma of the testis is rare, and its clinical behavior is difficult to predict. We report a case of paratesticular leiomyosarcoma in a 71-year-old man. Routine histologic examination and immunohistochemical staining were performed. The tumor was composed of interlacing fascicles of smooth muscle cells with marked nuclear pleomorphism and three to four mitoses per high power field, with few atypical mitoses. On the basis of the microscopic examination and immunohistochemical studies, the tumor was identified as a paratesticular leiomyosarcoma. The published studies on this entity are reviewed.

BILATERAL ASYNCHRONOUS PARATESTICULAR LEIOMYOSARCOMAS

Paratesticular tumors account for only 0.8% of adult soft tissue sarcomas and leiomyosarcomas comprise roughly 30% of the total, with the remainder being other mesenchymal sarcomas, including rhabdomyosarcoma (40%), liposarcoma and malignant fibrous histiocytoma.1 Leiomyosarcomas are thought to arise from undifferentiated mesenchymal cells of the cremasteric muscles, vas deferens, epididymal canal and dartos layers. The typical age at presentation is the forties to seventies. To our knowledge, we report the first case of bilateral paratesticular leiomyosarcomas.

Leiomyosarcoma of the paratesticular region: a clinicopathologic study.

The behavior of leiomyosarcoma (LMS) is site related, but there are limited data on such tumors presenting in the paratesticular region. Cases diagnosed as LMS of the paratesticular region from the files of three institutions were reviewed. Immunohistochemistry was performed in cases with available blocks, and follow-up information was obtained. From 31 cases originally diagnosed as LMS, 24 were retained after review. These were from men aged 34-86 years (mean 62 years; median 64 years) and involved the testicular tunica (10), spermatic cord (10), scrotal subcutis and dartos muscles (1 each), and the epididymis (1). Tumors ranged in size from 2-9 cm (mean 5 cm; median 4 cm). On immunohistochemical staining they expressed muscle-specific actin (13 of 14), smooth muscle actin (10 of 10), desmin (16 of 17), and CD34 (3 of 9); all of the latter three were strongly desmin-positive. Focal reactivity for cytokeratin (3 of 8) and S-100 protein (1 of 8) was seen. Follow-up information was available in 14 patients. Four (29%) had recurrences, in one case four times. Metastases to lymph nodes, lungs, or liver were seen in four patients (29%), of whom two had prior recurrences. Ten were alive with no evidence of disease (ANED), and four were dead of disease (DOD). Comparing outcome with tumor grade, all seven patients with grade 1 tumors (of whom two had recurrences) and all three with grade 2 tumors were ANED, whereas all four patients with grade 3 tumors were DOD. In summary, paratesticular LMSs are rare neoplasms. The majority in this site are low-grade, although high-grade lesions behave aggressively.

PRIMARY LEIOMYOSARCOMA OF THE EPIDIDYMIS AND LATE RECURRENCE ON THE PENIS

No AccessJournal of UrologyClinical Urology: Case Reports1 Feb 1998PRIMARY LEIOMYOSARCOMA OF THE EPIDIDYMIS AND LATE RECURRENCE ON THE PENIS Bernhard Planz, Kay Brunner, Tomislav Kalem, Rudiger W. Schlick, and Manfred Kind Bernhard PlanzBernhard Planz More articles by this author , Kay BrunnerKay Brunner More articles by this author , Tomislav KalemTomislav Kalem More articles by this author , Rudiger W. SchlickRudiger W. Schlick More articles by this author , and Manfred KindManfred Kind More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)63966-1AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "PRIMARY LEIOMYOSARCOMA OF THE EPIDIDYMIS AND LATE RECURRENCE ON THE PENIS." The Journal of Urology, 159(2), p. 508 References 1 : Leiomyosarcoma.. In: Soft Tissue Tumors.. St. Louis: The C. V. Mosby Co.1994: 491. chapt. 19. Google Scholar 2 : The management of spermatic cord sarcoma.. Cancer.1996; 77: 1873. Google Scholar 3 : A 37-pound scrotal leiomyosarcoma: case report and literature review.. J. Urol.1987; 138: 1245. Link, Google Scholar Departments of Urology and Pathology, Teaching Hospital of Fulda, Fulda, Germany, and Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 159Issue 2February 1998Page: 508 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information Bernhard Planz More articles by this author Kay Brunner More articles by this author Tomislav Kalem More articles by this author Rudiger W. Schlick More articles by this author Manfred Kind More articles by this author Expand All Advertisement PDF downloadLoading ...