Paratesticular Sarcomas Research Articles

Liposarcoma del cordón espermático

Introduction: liposarcoma of the spermatic cord (LSC) is a rare condition and accounts for about 3 to 7% of all paratesticular sarcomas. A case is presented in an 80-year-old patient who consulted for a left inguinoscrotal painless swelling, that had been present for several years. Physical examination revealed a soft left hemiscrotal tumor that appeared not to be adherent to the testicle. Ultrasonography showed a solid, heterogeneous hyperschoic paratesticular mass with central calcifications and peripheral hypervascularity. During surgery, a diffuse lipomatous tumor was found in the spermatic cord on the superior pole of the left testicle, separated from it. Anatomopathological examination revealed a well-differentiated liposarcoma of the spermatic cord. Discussion: this neoplasm features a slow-growing palpable paratesticular mass. This site of occurrence is rare and represents 7 to 10% of all scrotal tumors. Imaging differentiation between LSC and benign lesions is sometimes challenging. Surgical treatment should include radical orchiectomy wide local excision, and spermatic cord and inguinal ring surrounding soft tissue resection. Conclusion: spermatic cord liposarcoma is a rare and unusual mesenchymal tumor and should be considered among the differential diagnoses of scrotal tumors.

Adult genitourinary sarcomas: A single-centre experience over 25 years.

e23532 Background: Genitourinary sarcomas are a rare entity. This study is a retrospective review of the patient characteristics, types of adult GU sarcomas, treatments and outcomes in a single institution over the past 25 years. Methods: Survival probabilities were estimated and plotted using the Kaplan-Meier method. Estimates along with 95% pointwise confidence intervals were reported. Recurrence-free survival (RFS) is defined as time from when the patient was disease-free to recurrence. Otherwise, patients were censored at last disease evaluation. OS was defined as time from when the patient was disease-free to death due to any cause. Patients still alive were censored at last known alive. Results: 29 patients presented with various types of GU sarcomas, with the majority being paratesticular tumors (n = 22, 75.9%). Others included bladder leiomyosarcomas (n = 5), prostatic leiomyosarcoma (n = 1), renal leiomyosarcoma (n = 1). Median age for diagnosis was 51 years (range: 21-79) for leiomyosarcoma vs 61 (range: 36-89) for liposarcoma. Among the paratesticular tumors majority were (n = 16) were liposarcoma, remaining 5 being leiomyosarcoma and 1 being rhabdomyosarcoma. Majority tumors were stage III and above (n = 16, 55.17%), high and intermediate grade (65.51%). All tumors were resected ± adjuvant therapy (n = 4). Leiomyosarcomas had a higher stage (66%) and grade (83%) at diagnosis, recurrence rate was also higher at 37.5% (vs 6.6% for liposarcoma) along with a higher mortality (41.6%). Commonest site of recurrence for leiomyosarcoma was the lungs (n = 3, 100%). Treatment for recurrence commonly involved radiotherapy, pembrolizumab etc. Paratesticular liposarcomas were found to be associated with a lipomatosis syndrome with n = 5 (31.25%) having lipomas elsewhere in the body and n = 2 (12.5%) patients having had previously resected spermatic cord lipoma. Paratesticular sarcomas often required (n = 15, 68%) revision surgery due to being initially diagnosed as a hernia, cord lipoma or hydrocele and requiring high ligation of the cord with hemiscrotectomy and radical orchiectomy ± LND on revision surgery, which often demonstrated a focus of residual tumor in liposarcomas (n = 5, 31%). N = 4 patients (25%) had positive margins in spite of revision surgery. Majority of these were MDM2+ positive on FISH (n = 9, 56%). Overall, GU sarcomas had an RFS of 63% (53-94%) and OS of 82% (53-94%) at 36 months since NED was achieved. The median length of follow-up was 19.9 months for leiomyosarcoma, 33.8 months for liposarcoma. Conclusions: Leiomyosarcomas in adults have worse outcomes compared to other GU sarcomas especially if it originates in the bladder. [Table: see text]

Familial syndromes associated with testicular and paratesticular neoplasms: a comprehensive review.

A syndromic association between a subset of testicular/paratesticular neoplasms is well established. Such examples include Carney complex and large cell calcifying Sertoli cell tumor, Peutz-Jeghers syndrome and intratubular large cell hyalinizing Sertoli cell neoplasia, and VHL syndrome and clear cell papillary cystadenoma of the epididymis.However, recent studies proposed potential novel links between some testicular and paratesticular neoplasms with certain tumor syndromes. While more studies are still needed to solidify these associations, recent research suggests that a subset of Leydig cell tumors may arise in patients with hereditary leiomyomatosis and renal cell carcinoma syndrome or that some seminomas may occur in Lynch syndrome patients. Additionally, an association between testicular sex cord stromal tumors and paratesticular sarcomas with Familial adenomatous polyposis syndrome and DICER1 syndrome, respectively, has been proposed as well. This review provides a comprehensive overview of the intricate relationship between familial syndromes and associated testicular and paratesticular tumors, shedding light on their clinicopathological and molecular characteristics.

Après-Ski: A Shout Out to Winter Sports-Themed Urologic Education

Après-Ski: A Shout Out to Winter Sports-Themed Urologic Education

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

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.

Robotic retroperitoneal lymphadenectomy in paratesticular rhabdomyosarcoma

Paratesticular sarcoma is an aggressive malignanttumor of mesenchymal origin. The rhabdomyosarcoma is the most common among children.Rhabdomyosarcoma treatment consists ofsurgery, chemotherapy and radiotherapy. Prognosicdepends on local recurrence and distant metastasis. We present the case of a 16-year-old male, who inApril 2016 underwent right radical orchiectomy surgery by testicular mass rapidly evolving, with pathological results indicating a paratesticular rhabdomyosarcoma. The extension study showed aprecaval adenopathy suggestive of lymph nodemetastasis, therefore it was a high-grade rhabdomyosarcoma. There was an appropriate response after chemotherapy (Protocol EpSSG RMS2005) andwe decided to perform a robotic lymphadenectomy. We performed a transperitoneal approach with 8mm trocar and 12mm optica trocar. We accessed the retroperitoneal space through a latero-colic incision. Then we performed a craniocaudal lymph node dissection until the aortic bifurcation. The surgical time was 240min with a blood loss of 200ml. There were no complications. The patient was discharged on the fourth day after surgery. Pathology showed metastasis of rhabdomyosarcoma without capsular rupture. After two months, we placed the left testicle into inguinal canal prior to radiotherapy. Robotic lymph node metastasis lymphadenectomy from paratesticular sarcomas is a feasible treatment with the advantage of minimally invasive surgery and acceptable morbidity.

Rare intrascrotal tumors in a tertiary cancer center: A retrospective case series.

415 Background: Given their rarity, the literature on non-germ cell testicular tumors and paratesticular malignancies is still scarce. The objective of this study is to describe clinical and pathological features, as well as treatment patterns and outcomes, of patients with non-germ cell intrascrotal malignancies. Methods: Patients (pts) with benign or malignant non-germ cell intrascrotal tumors who were older than 18 years-old were deemed eligible. Electronic health records (EHR) were reviewed to assess pts clinical features, and disease characteristics and outcomes. Descriptive statistics was used to report data. RECIST 1.1 was used to determine radiological response to treatment. Time-to-event variables were estimated by the Kaplan-Meier method. Results: EHR of 885 pts with a primary diagnosis of ICD-10 C62 treated in a tertiary cancer center from January 2009 to June 2020 were reviewed for eligibility. 29 pts fulfilled eligibility criteria (Sertoli cell tumors, N = 3; Leydig cell tumors, N = 6; granulosa cell tumor, N = 1; testicular tumor of the androgenital syndrome, N = 1; mesotheliomas, N = 3; liposarcomas, N = 3; leiomyosarcomas N = 2; rhabdomyosarcomas, N = 3; spindle cell sarcomas, N = 3; lymphomas, N = 2; carcinoma of the rete testis, N = 1; primary neuroendocrine tumor of the testis, N = 1). The majority of pts (N = 25) had non-metastatic disease at diagnosis, and underwent upfront orchiectomy. The remaining four patients had metastatic disease at diagnosis (lymphoma, N = 1; sarcomas, N = 3), all positive for lymph node (LN) involvement; one with concurrent visceral metastasis. Six other pts posteriorly developed metastatic disease after a median follow-up of 13 months (IQR: 5.8–33.1 months) (Leydig tumor, N = 1; mesothelioma, N = 2; sarcomas, N = 3). The most common metastatic sites were LN (N = 8, 80%), lung (N = 4, 40%), bone (N = 3, 30%), adrenal gland (N = 2, 20%), peritoneum (N = 1, 10%), and skin (N = 1, 10%). Nine pts (90%) received systemic treatment: vincristine, doxorubicin and cyclophosphamide for rhabdomyosarcomas (N = 3), cisplatin plus pemetrexed for mesotheliomas (N = 2), doxorubicin for liposarcomas (N = 2), doxorubicin plus ifosfamide for liposarcoma (N = 1) and doxorubicin, vincristine, cyclophosphamide, and prednisone plus rituximab for lymphoma (N = 1). Of those, 2 pts achieved partial response and 2 had stable disease. Metastasectomy of a single lung metastasis was performed in a patient with metastatic Leydig cell tumor. Median overall survival was 51.2 and 24.5 months for patients with localized and metastatic disease, respectively. Conclusions: Paratesticular and non-germ cell testicular tumors are extremely rare entities with relatively good prognosis if treated at early stages depending on the underlying histology. Most metastatic disease cases were due to paratesticular sarcomas.

Testicular, Spermatic Cord, and Scrotal Soft Tissue Sarcomas: Treatment Outcomes and Patterns of Failure.

Introduction Paratesticular sarcomas are defined as tumors that arise within the scrotum and include the subsites of epididymis, spermatic cord, and tunica vaginalis and represent the most common type of GU sarcoma. The mainstay of treatment is often surgical resection, combined with histology specific chemotherapy and radiotherapy. Due to the rare nature of the disease, there are limited data to guide management. We present our single-institution retrospective experience regarding the management and treatment of paratesticular sarcomas. Materials and Methods We queried our oncology registry database for patients treated for testicular, spermatic cord, and scrotal soft tissue sarcomas between 1971 and 2017. Patients in this series had pathological confirmation of a sarcoma diagnosis by a sarcoma-specialized pathologist. Only patients with localized disease were included in this analysis with the exception of patients with a diagnosis of rhabdomyosarcoma where patients with both localized and metastatic disease were included on this study. Results A total of 34 patients were included in this retrospective analysis. The median was 24 (range, 5–78), and the median tumor size was 6.25 cm. Twenty-six patients had localized disease (76.6%) at the time of diagnosis. A predominance of patients had tumors involving the spermatic cord (45.5%), and the most common histology was rhabdomyosarcoma (35.3%), leiomyosarcoma (26.5%), and well-differentiated liposarcoma (23.5%). The median follow-up was 71.0 months (range, 2.5–534.4 months). A total of 7 patients experienced an isolated local failure (20.6%), four patients developed distant metastatic disease (11.8%), and one patient (2.9%) with synovial sarcoma of the spermatic cord experienced a regional recurrence. The median progression-free survival (PFS) was 99.6 months, 95% CI (45.8–534.3 months), with a three-year PFS rate of 71%, 95% CI (53%–83%), and a 5-year PFS rate of 64% (range, 46%–78%). We did not find any statistically significant associations based on surgery type (p=0.15), the use of chemotherapy, (p=0.36), or final margin status (p=0.21). Two patients who were treated with preoperative radiotherapy had significant wound healing complication with chronic sinus tracts, though these patients did not experience a local recurrence. Conclusions We provide a characterization of the natural history and treatment patterns of paratesticular sarcomas. While effective at reducing a local recurrence, preoperative radiotherapy was associated with significant toxicity. As a result, we prefer the use of postoperative radiotherapy in patients as clinically indicated. We did not find any specific treatment patterns associated with an improvement in clinical outcomes.

Identifying Patterns of Failure and Risk Factors for Recurrence in Patients of Paratesticular Sarcomas: Protocol of a Systematic Review and Meta-Analysis.

Introduction:Para testicular sarcomas are rare mesenchymal tumors that affect patients of all ages. Unlike other sites of sarcoma, they tend to be of lower grade and have a higher propensity for lymphatic spread. Management is hampered by the small number of patients who differ in terms of tumor grade and histology. Current treatment approaches are based on case reports, small case series and literature reviews, resulting in a number of unresolved issues. The consensus on the type of surgery and adjuvant treatment is yet to be determined. The local relapse rates in the scrotum and groin after orchidectomy comes out to be 25%–37%, indicating the need for either aggressive surgery or adjuvant treatment. There is a paucity of data identifying the patterns of failure and risk factors for recurrence, which will help clinicians tailor appropriate treatment.Methods:We aim to perform a systematic review and meta-analysis of the available data in the last 50 years in a methodologically rigorous and transparent manner to identify patterns of failure and high-risk factors for recurrence. The protocol is prepared in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA-P) 2015 guidelines. The protocol is registered in the International Prospective Register of Systematic Reviews (CRD42021237134).HighlightsPara testicular sarcomas are rare mesenchymal tumors that affects patients of all ages. Current treatment approaches are based on case reports, small case series and literature reviews, resulting in a number of unresolved issues. A systemic review was performed in 2013 based on survival rates, prognostic factors, and relapse sites on paratesticular sarcomas. However, it lacks a comprehensive review that can guide radiation oncologists to select in which patient’s postoperative radiotherapy is warranted and define the target volume based on histopathological type, stage, and grade of the tumor. After 2013, new case series with improved methodology and sample size are published, which adds new information to the literature. In one case series, 22 patients with spermatic cord sarcoma were discussed, while in another study, long-term outcome analysis of 51 patients was discussed, and another study discussed eight patients.

Epidydimal leiomyosarcoma: a rare case of scrotal swelling

Sarcomas of the genitourinary tract are extremely uncommon and accounts for only 1-2% of genito urinary malignancies. Sarcomas of the para testicular region, comprising tissues such as the epididymis, spermatic cord, inguinal canal and testicular tunica are also extremely rare. epidydimal leiomyosarcoma accounted only for 4 percentage of all para testicular tumours and only 16 cases are reported so far in literature and they account 4% of all Para testicular sarcomas. We are presenting a 61-year-old patient presented with a hard welling of 1 year duration, with no other associated symptoms. On ultrasound evaluation, it was reported as extra testicular lesion, possibly from epididymal tail. We performed a high inguinal orchidectomy. Histopathological examination revealed a para testicular leiomyosarcoma arising from epididymis. This case has discussed because of the rarity of the disease and possible cure if diagnosed early and treated aggressively.

Letter to the editor re: Paratesticular sarcomas: a case series and literature review: Keenan et al.

Letter to the editor re: Paratesticular sarcomas: a case series and literature review: Keenan et al.

Experience of paratesticular sarcomas in a single insitution - A case series

Experience of paratesticular sarcomas in a single insitution - A case series

290 Rhabdomyosarcomatous Differentiation in a Testicular Germ Cell Tumor Determined by FISH Detection of 12p11.21 Duplication

Testicular germ cell tumors (GCTs) with sarcomatous differentiation are rare. They may have histological features identical to paratesticular sarcomas and hence specific molecular diagnostic markers can be useful to establish a definitive diagnosis. A 34-year-old man presents with painless scrotal swelling of 4 months’ duration with midline back pain. On examination, he had a painless firm mass in the scrotum, and CT showed a large testicular mass, an L5 compression fracture, and a right lung lower lobe nodule. Serologic evaluation revealed elevated LDH (1.54x normal), and normal AFP and HCG. Right radical orchiectomy was performed. The specimen weighed 1,348 g, and the testis was entirely replaced by a fleshy focally hemorrhagic and necrotic mass measuring 14.9 x 13.5 x 12.9 cm. Histologically, the tumor cells were ovoid to spindled with hyperchromatic nuclei and areas of rhabdomyoblastic differentiation exhibiting cross striations. Architecturally, the tumor formed fascicles without any other identifiable growth pattern typical of a mixed germ cell tumor. Immunoperoxidase stains for desmin, Myo-D1, myogenin, and MSA were positive, consistent with a diagnosis of rhabdomyosarcoma, embryonal type. However, the differential diagnosis included both primary rhabdomyosarcoma such as that arising within the paratesticular soft tissue and secondary rhabdomyosarcomatous differentiation of a testicular GCT. Given that sarcomas deriving from GCT often retain signature chromosomal anomalies such as isochromosome 12p, FISH studies were performed. FISH did not detect isochromosome 12p but demonstrated ~99% of tumor cells had duplication of the 12p11.21 region, which is a less common, but reported, abnormality in GCT. The differential diagnosis of intrascrotal sarcoma includes both primary paratesticular sarcomas as well as secondary sarcomatous transformation of testicular GCT. Extensive histological sampling and cytogenetic analysis for signature chromosomal anomalies in testicular germ cell tumors may be helpful in establishing a diagnosis when a non-sarcomatous element is not demonstrated.

Paratesticular liposarcoma in an adolescent male: Case report of a rare tumor

Paratesticular liposarcomas (PLs), first reported in 1952, are rare tumors that comprise approximately 3%–7% of all paratesticular sarcomas. PL of unknown etiology typically affects adults aged 50–60 years and rarely occurs in the young. Here, we report one case of an 18-year-old male patient presenting with a mobile, firm, painless, and nontender testicular mass measuring about 7 cm in greatest dimension. Testicular tumor markers were negative. On cytological (fine-needle aspiration cytology) examination, features were suggestive of a malignant mesenchymal tumor. Subsequently, he underwent radical orchiectomy along with high ligation of the spermatic cord. A wide local scrotal excision was also done, which was followed by histopathological examination. A diagnosis of PL was made which was confirmed by immunohistochemical examination with vimentin positive and negative for desmin and myogenin. Since there is no definite consensus of opinion as regards to the role of adjuvant radiotherapy and chemotherapy, the patient received none. He remained recurrence free after an 18-month regular follow-up.

Paratesticular Sarcoma: Typical Presentation, Imaging Features, and Clinical Challenges

To describe the major imaging features, together with clinical data, of paratesticular sarcomas. 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. 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. 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.

Commentary on “A Case of Paratesticular Leiomyosarcoma Successfully Treated with Orchiectomy and Chemotherapy”

Commentary on “A Case of Paratesticular Leiomyosarcoma Successfully Treated with Orchiectomy and Chemotherapy”

Paratesticular Liposarcoma of the Spermatic Cord: A Rare Case

Spermatic cord liposarcomas (LPS) are rare representing 7% of paratesticular sarcomas. The most present as slow growing inguinal or scrotal masses that need to be differentiated from inguinal hernias, testicular tumors, hydrocele, and benign lipomas. A 57-year-old male presented with right scrotal swelling since 1 year that grew rapidly in last 4 months. On examination, a firm, nontender mass was felt in the right scrotum measuring 12 cm × 8 cm. A clinical diagnosis of right testicular tumor was made. Ultrasound scrotum large, heteroechoeic mass separate from right testis. Magnetic resonance imaging scrotum well-defined, homogenously enhancing extra testicular mass with fat component? Paratesticular lipoma/liposarcoma. Right radical orchiectomy, high ligation of spermatic cord, and excision of mass en bloc were performed. Gross findings: Multiple, globular, gray yellow, firm masses seen in the paratesticular area and spermatic cord, the largest measuring 11 cm × 7 cm × 5 cm. Testis, epididymis-normal. Cut surface–solid, yellowish white with myxoid areas. Microscopy-mature adipocytes of varying sizes separated by dense fibrillary fibrocollagenous stroma with pleomorphic, bizarre stromal cells, and multinucleate giant cells. Interspersed areas showed extensive mast cell infiltration and myxoid change. Diagnosis, well-differentiated liposarcoma/atypical lipomatous tumor sclerosing type of paratesticular area (spermatic cord). Paratesticular LPS of spermatic cord are rare tumors often misdiagnosed clinically resulting in incomplete excision and high recurrences. This report highlights the need of considering liposarcoma as a differential diagnosis in inguinoscrotal masses and stresses the role of histopathological examination in making a definitive diagnosis, which cannot be established clinically/radiologically.

Paratesticular sarcomas: A report of seven cases

Primary tumors of the paratesticular region are rare, with paratesticular sarcomas constituting a major proportion of these tumors, particularly in the elderly. The paratesticular region consists of mesothelial, various epithelial and mesenchymal cells and may therefore give rise to a number of tumors with various behaviors. Defining the association between the paratesticular mass and the testicle, and differentiation between benign and malignant masses using radiology is challenging, therefore the mass is usually considered to be malignant and radical orchiectomy with high ligation is performed. The present study reports the cases of seven patients with tumors of the paratesticular region and presents the clinical and significant histological features of the tumors. In total, two patients suffered from dedifferentiated liposarcoma (DDLS), two exhibited leiomyosarcoma, two exhibited low-grade fibromyxoid sarcoma and one case of undifferentiated pleomorphic sarcoma was identified. Radical orchiectomy with high ligation was performed in five cases; simple orchiectomy was performed in one case and excisional biopsy was performed in the remaining case. A leiomyosarcomatous and epithelial membrane antigen (EMA) positive whorl pattern was observed during microscopy in the two DDLS cases. Additionally, one of the low-grade fibromyxoid sarcoma patients exhibited pleomorphism and mitosis in focal areas. To the best of our knowledge, the present study is the second time low-grade fibromyxoid sarcoma cases with paratesticular localization have been reported in the literature. Of the seven cases, four patients succumbed to the disease, one patient is living with the disorder and the two cases of DDLS are living without the disease. Paratesticular sarcomas are often aggressive and a multidisciplinary approach is required for the diagnosis and treatment of these tumors.

Paratesticular sarcomas: our case series.

Paratesticular tumors, which comprise a heterogeneous group of entities, are often described in case reports in the literature. In this study, we present histomorphological, immunohistochemical and clinical features of six cases with paratesticular sarcoma. Six cases with paratesticular sarcoma diagnosed in our hospital between 1997 and 2012 were included in this study. Information regarding treatment modalities, tumor recurrence, metastasis, and survival were obtained from archival patient records. Hematoxylin-eosin sections of the cases were examined, and immunohistochemical analyses were performed for markers including smooth muscle actin, desmin, Ki67, CD34, S100 and myogenin. Percentage of staining in five high-power fields were counted to document Ki67 and p53 nuclear positivity rates. Of the 6 paratesticular sarcoma cases, 3 were rhabdomyosarcomas, 2 leiomyosarcomas and 1 liposarcoma. The case with sclerotic-type liposarcoma showed two recurrences during the 15-year follow-up period. Two cases with the diagnosis of leiomyosarcoma presented with lung metastases at the time of diagnosis, and 1 patient died of the disease at 7(th) month. Of the 3 cases with rhabdomyosarcomas, 2 patients were lost to postoperative follow up. The other patient presented with liver and prevertebral metastasis at the 3(rd) month and died of the disease in the 14(th) month. The Ki67 proliferation index was significantly higher for one case with rhabdomyosarcoma, and 2 cases with leiomyosarcoma. Differences in p53 expression were not statistically significant between the cases. Paratesticular tumors belong to a heterogeneous group of tumors that can follow different clinical courses. This study showed that the most important features in determining prognosis are histopathological subtype and tumor grade.

A rare case: paratesticular leiomyosarcoma

A rare case: paratesticular leiomyosarcoma