Case report on paratesticular sarcoma and a focused review of the literature
Abstract
Insidious, usually painless, and rare inguinoscrotal masses arising from paratesticular elements (spermatic cord, epididymis, tunica or the stroma) are known as paratesticular tumors. The overall incidence is less than 5%, and the total number of giant (>10cm) paratesticular liposarcomas is less than 300 cases recorded since 2020. We report a similar clinical dilemma of a giant scrotal mass managed via a wide local resection and close surveillance in a 61 year old male. However, owing to its rarity, there is no fixed treatment protocol; hence, a supplementary review of similar cases is discussed here.
References
Matias M, Carvalho M, Xavier L, Teixeira JA. Paratesticular sarcomas: two cases with different evolutions. BMJ Case Rep. 2014 Aug 21; doi:10.1136/bcr-2014-205808.
Vogelzang N. Comprehensive textbook of genitourinary oncology. Lippinkot Williams & Wilkins; 2000.
Coleman J, Brennan MF, Alektiar K, Russo P. Adult spermatic cord sarcomas: Management and results. Ann Surg Oncol. 2003;10(6):669–75.
Kamitani R, Matsumoto K, Takeda T, Mizuno R, Oya M. Optimal treatment strategy for paratesticular liposarcoma: retrospective analysis of 265 reported cases. Int J Clin Oncol. 2020 Dec;25(12):2099–106.
Kin T, Kitsukawa S, Shishido T, Maeda Y, Izutani T, Yonese J, et al. Two cases of giant testicular tumor with widespread extension to the spermatic cord: usefulness of upfront chemotherapy. Hinyokika Kiyo. 1999 Mar;45(3):191–4.
Coindre JM, Trojani M, Contesso G, David M, Rouesse J, Bui NB, et al. Reproducibility of a histopathologic grading system for adult soft tissue sarcoma. Cancer. 1986 Jul 15;58(2):306–9.
Trojani M, Contesso G, Coindre JM, Rouesse J, Bui NB, De Mascarel A, et al. Soft-tissue sarcomas of adults; study of pathological prognostic variables and definition of a histopathological grading system. Int J Cancer. 1984;33(1):37–42.
Hinman F, Gibson Te. Tumors of the epididymis, spermatic cord and testicular tunics: A Review of the literature and report of three new cases. Arch Surgery. 1924; 8(1):100-137. doi:10.1001/archsurg.1924.01120040111005.
Akbar SA, Sayyed TA, Jafri SZH, Hasteh F, Neill JSA. Multimodality imaging of paratesticular neoplasms and their rare mimics. Radiographics. 2003;23(6):1461–76.
Etchebehere EC, Hobbs BP, Milton DR, Malawi O, Patel S, Benjamin RS, et al. Assessing the role of 18F-FDG PET and 18F-FDG PET/CT in the diagnosis of soft tissue musculoskeletal malignancies – A systematic review and meta-analysis. Eur J Nucl Med Mol Imaging. 2016 May 1;43(5):860.
Sambri A, Bianchi G, Longhi A, Righi A, Donati DM, Nanni C, et al. The role of 18F-FDG PET/CT in soft tissue sarcoma. Nucl Med Commun. 2019 Jun 1;40(6):626–31.
Beech DJ, Pollock RE. Surgical management of primary soft tissue sarcoma. Hematol Oncol Clin North Am. 1995 Aug;9(4):707–18.
Li Z, Zhou L, Zhao L, Chen P, Liu Y, Ding Y, et al. Giant paratesticular liposarcoma: A case report and review of the literature. Mol Clin Oncol. 2018 Feb 15;8(4): 613-16. doi:10.3892/mco.2018.1577.
Chowdhry VK, Kane JM, Wang K, Joyce D, Grand’maison A, Mann GN. Testicular, Spermatic Cord, and Scrotal Soft Tissue Sarcomas: Treatment Outcomes and Patterns of Failure. Sarcoma. 2021. doi: 10.1155/2021/8824301.
