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Agarwal S, Bains L, Makthala S, Lal P, Singh M. An inguinal enigma: Myxoid liposarcoma in a female. Clin Case Rep 2023; 11:e7209. [PMID: 37091969 PMCID: PMC10114096 DOI: 10.1002/ccr3.7209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/19/2023] [Accepted: 03/29/2023] [Indexed: 04/25/2023] Open
Abstract
Myxoid liposarcoma of the inguinal region is rare, can mimics an inguinal hernia. Any swelling in the inguinal region, that is partially reducible, fluctuant, soft, and without any signs of bowel obstruction should be evaluated further.
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Affiliation(s)
- Shantanu Agarwal
- Department of General SurgeryMaulana Azad Medical CollegeNew DelhiIndia
| | - Lovenish Bains
- Department of General SurgeryMaulana Azad Medical CollegeNew DelhiIndia
| | - Sripooja Makthala
- Department of General SurgeryMaulana Azad Medical CollegeNew DelhiIndia
| | - Pawan Lal
- Department of General SurgeryMaulana Azad Medical CollegeNew DelhiIndia
| | - Meeta Singh
- Department of PathologyMaulana Azad Medical CollegeNew DelhiIndia
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2
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Caviglia A, Beverini M, Pacchetti A, Branger N, Pignot G, Bertucci F, Walz J. A Giant Paratesticular Liposarcoma: Case Report and Literature Review. Case Rep Oncol 2023; 16:162-166. [PMID: 36970715 PMCID: PMC10035545 DOI: 10.1159/000528221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/02/2022] [Indexed: 03/25/2023] Open
Abstract
Liposarcoma of the spermatic cord (LSC) is a very rare disease. In literature, are reported less than 350 cases. Genitourinary sarcomas account for <5% of all soft-tissue sarcomas and <2% of malignant urologic tumours. An inguinal mass is the clinical presentation, which can mimic a hernia or hydrocele. Since it is such a rare disease, there are insufficient data on chemotherapy and radiotherapy, and in any case, the data come from low-level scientific evidence. Here, we report the case of a patient who came to the observation for a giant inguinal mass, in which a definitive diagnosis was obtained with the histological examination.
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Affiliation(s)
- Alberto Caviglia
- Department of Urology, Institut Paoli-Calmettes, Marseille, France
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Martina Beverini
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Department of Urology, UMC+, Maastricht, The Netherlands
| | | | - Nicolas Branger
- Department of Urology, Institut Paoli-Calmettes, Marseille, France
| | - Geraldine Pignot
- Department of Urology, Institut Paoli-Calmettes, Marseille, France
| | | | - Jochen Walz
- Department of Urology, Institut Paoli-Calmettes, Marseille, France
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3
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Hua R, Zhao L, Xu L, Sun J, Huang J, Hua Q. Recurrent paratesticular giant liposarcoma: A case report and literature review. Front Surg 2023; 10:1171952. [PMID: 37181598 PMCID: PMC10172677 DOI: 10.3389/fsurg.2023.1171952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/31/2023] [Indexed: 05/16/2023] Open
Abstract
Background Primary paratesticular liposarcoma is rarely diagnosed among urinary tumors. In this study, through the retrospective analysis of clinical data and literature review, a case of recurrent paratesticular liposarcoma with lymph node metastasis after radical resection has been reported to explore novel strategies for the diagnosis, treatment and prognosis of this rare disease. Case summary The present case involved a patient who was misdiagnosed as a left inguinal hernia for the first time two years ago, but was later diagnosed as mixed liposarcoma by using postoperative pathology. Currently, he is readmitted to the hospital with a recurrence of the left scrotal mass for more than 1 year. Combined with the patient's past medical history, we performed radical resection of the left inguinal and scrotal tumors and lymphadenectomy of left femoral vein. The postoperative pathology indicated that well-differentiated liposarcoma was accompanied by mucinous liposarcoma (about 20%), and lymph node metastasis of left femoral vein both of which occurred at the same time. After the operation, we recommended the patient to receive further radiation therapy, but the patient and his family refused, hence we followed up the patient closely for a long time. During the recent follow-up, the patient reported no complaints of discomfort, and no recurrence of mass in the left scrotum and groin area. Conclusion After conducting extensive review of literature, we conclude that radical resection remains the key to treat primary paratesticular liposarcoma, while the significance of the lymph node metastasis is still unclear. The potential effects of postoperative adjuvant therapy depends on the pathological type, and hence close follow-up observation is essential.
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Affiliation(s)
- Runmiao Hua
- Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Liwei Zhao
- Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Li Xu
- Department of Urology, School of Medicine, Hangzhou Normal University, Hangzhou, China
| | - Ji Sun
- Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Jiaguo Huang
- Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Qiyan Hua
- Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
- Correspondence: Qiyan Hua
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4
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[The special case-Dedifferentiated liposarcoma of the spermatic cord]. CHIRURGIE (HEIDELBERG, GERMANY) 2023; 94:67-70. [PMID: 35960320 DOI: 10.1007/s00104-022-01698-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/17/2022] [Indexed: 01/21/2023]
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Pavone G, Romano C, Martorana F, Motta L, Salvatorelli L, Zanghì AM, Magro G, Vigneri P. Giant Paratesticular Liposarcoma: Molecular Characterization and Management Principles with a Review of the Literature. Diagnostics (Basel) 2022; 12:diagnostics12092160. [PMID: 36140560 PMCID: PMC9498211 DOI: 10.3390/diagnostics12092160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/01/2022] [Accepted: 09/04/2022] [Indexed: 11/29/2022] Open
Abstract
Paratesticular liposarcomas are extremely rare malignant tumors originating from fat tissues, with an often-challenging diagnosis. We present here the case of a 76-year-old man with a giant paratesticular liposarcoma, initially misdiagnosed as a scrotal hernia. After two years, the progressively enlarging mass underwent surgical resection, and a diagnosis of well-differentiated liposarcoma (lipoma-like subtype) was made. Post-operative treatments were not indicated, and the patient remains relapse free. Next generation sequencing performed on the neoplastic tissue showed co-amplification of MDM2 and CDK4. These alterations are molecular hallmarks of well-differentiated liposarcomas and corroborate the histological diagnosis. Clinical and molecular features of the presented case are in line with the majority of previously published experiences. In conclusion, the presence of a liposarcoma should be taken into account during the diagnostic workup of scrotal masses, in order to minimize the rate of misdiagnosis and improper management. Molecular analysis may support histological characterization of these rare entities and potentially disclose novel therapeutic targets.
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Affiliation(s)
- Giuliana Pavone
- Division of Medical Oncology, A.O.U. Policlinico “G. Rodolico–San Marco”—Catania, Via Santa Sofia, 78, 95123 Catania, Italy
- Correspondence:
| | - Chiara Romano
- Center of Experimental Oncology and Hematology, A.O.U. Policlinico “G. Rodolico–San Marco”—Catania, Via Santa Sofia, 78, 95123 Catania, Italy
- Department of Medical and Surgical Sciences and Advanced Technology G. F. Ingrassia, A.O.U. Policlinico “G. Rodolico–San Marco”—Catania, Via Santa Sofia, 87, 95123 Catania, Italy
| | - Federica Martorana
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Lucia Motta
- Division of Medical Oncology, A.O.U. Policlinico “G. Rodolico–San Marco”—Catania, Via Santa Sofia, 78, 95123 Catania, Italy
| | - Lucia Salvatorelli
- Department of Medical and Surgical Sciences and Advanced Technology G. F. Ingrassia, A.O.U. Policlinico “G. Rodolico–San Marco”—Catania, Via Santa Sofia, 87, 95123 Catania, Italy
| | - Antonio Maria Zanghì
- Department of Medical and Surgical Sciences and Advanced Technology G. F. Ingrassia, A.O.U. Policlinico “G. Rodolico–San Marco”—Catania, Via Santa Sofia, 87, 95123 Catania, Italy
| | - Gaetano Magro
- Department of Medical and Surgical Sciences and Advanced Technology G. F. Ingrassia, A.O.U. Policlinico “G. Rodolico–San Marco”—Catania, Via Santa Sofia, 87, 95123 Catania, Italy
| | - Paolo Vigneri
- Division of Medical Oncology, A.O.U. Policlinico “G. Rodolico–San Marco”—Catania, Via Santa Sofia, 78, 95123 Catania, Italy
- Center of Experimental Oncology and Hematology, A.O.U. Policlinico “G. Rodolico–San Marco”—Catania, Via Santa Sofia, 78, 95123 Catania, Italy
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
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Jin X, Tang H, Chen H, Chen G. Case Report: Metastatic Signet-Ring-Cell Carcinoma of the Bladder From Breast Invasive Lobular Carcinoma Detected by Computed Tomography. Front Oncol 2022; 12:835487. [PMID: 35252006 PMCID: PMC8888881 DOI: 10.3389/fonc.2022.835487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/31/2022] [Indexed: 12/13/2022] Open
Abstract
Secondary bladder tumors are relatively rare among all bladder tumors, while bladder metastases from breast cancer have been rarely reported. Furthermore, signet-ring differentiation may appear in the metastases from a breast invasive lobular carcinoma regardless of whether the primary breast tumor had signet-ring cells, which may cause diagnostic uncertainty. We report a case of a 55-year-old female patient with diffuse bladder thickening as the chief complaint and no specific clinical manifestations. While the cystoscopy showed multiple scattered red protuberances, the biopsy suggested signet-ring-cell carcinoma. The gastroscopy results suggested poorly differentiated adenocarcinoma with signet-ring cells. Considering the patient’s history of invasive lobular carcinoma of the breast, chronic myeloid leukemia, and metastatic endometrial carcinoma from the breast, we performed an immunohistochemical analysis and the results indicated that signet-ring-cell carcinomas of the stomach and bladder originated from the invasive lobular carcinoma of the breast. We performed positron emission tomography/computed tomography and the results showed that there were multiple bone metastases already present. This was the first English case report of invasive lobular carcinoma of the breast metastasizing to the uterus, stomach, bladder, and bones with multiple signet-ring-cell variations. This study shares our reasons for misdiagnosing and opinions on diagnosing and treating for this kind of cases.
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7
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Bansal S, Gupta S. Paratesticular Liposarcoma Mimicking Inguinal Hernia: a Case Report. Indian J Surg 2021. [DOI: 10.1007/s12262-020-02499-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Ramanathan S, Raghu V, Kumar D, Sempiege VRP. Sclerosing liposarcoma of epididymis: Role of chemical shift magnetic resonance imaging. Indian J Radiol Imaging 2021; 26:356-359. [PMID: 27857462 PMCID: PMC5036334 DOI: 10.4103/0971-3026.190425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Sclerosing liposarcoma of epididymis is a rare extratesticular scrotal tumor with variable prognosis. Ultrasonography is the initial imaging modality of choice for the evaluation of scrotal mass and helps to differentiate testicular and extratesticular masses, thereby narrowing down the differential diagnosis. Magnetic resonance imaging with its excellent soft tissue resolution can help in the further characterization of the nature of the tumor. In this case report, we highlight the role of chemical shift imaging in making a confident preoperative diagnosis of liposarcoma thereby guiding optimal and timely management.
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Affiliation(s)
| | - Vineetha Raghu
- Department of Radiology, Consultant Radiologist, NU West, Rajajinagar, Bangalore, India
| | - Devendra Kumar
- Department of Clinical Imaging, Hamad Medical Corporation, Doha, Qatar
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Ebey BN, Naouar S, Faidi B, Lahouar R, Ben Khalifa B, El Kamel R. Pleomorphic spermatic cord liposarcoma: A case report and review of management. Int J Surg Case Rep 2021; 81:105725. [PMID: 33740530 PMCID: PMC7995474 DOI: 10.1016/j.ijscr.2021.105725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/28/2021] [Accepted: 03/03/2021] [Indexed: 11/17/2022] Open
Abstract
Liposarcoma of the spermatic cord is very rare, representing about 7% of para testicular sarcomas. It is considered to be one of the highest malignancy grades. We present a case of a liposarcoma of the spermatic cord in a 45-year-old male complaining of a progressive painless swelling in the right inguinoscrotal region. Ultrasonography and computed tomography findings were compatible with liposarcoma of the spermatic cord. We performed a right radical orchiectomy with a wide resection of the mass. Histological examination confirmed the diagnosis and showed a pleomorphic subtype. The mainstay of management of spermatic cord liposarcoma is wide excision with radical orchiectomy. The most important factors for prognosis are the histologic subtype and surgical margin status. Adjuvant radiotherapy should be considered in cases at high risk for local recurrence. Long-term surveillance is mandatory. Liposarcoma of the spermatic cord is an uncommon para testicular tumor which should be part of the differential diagnosis of inguinoscrotal mass. A radical inguinal orchiectomy with wide resection of the soft tissue mass and the spermatic cord are the key to longest local and systemic disease-free survival.
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Affiliation(s)
- Babe Nejib Ebey
- Urology Department, Les Aghlabides Surgical Division, Ibn Jazzar Teaching Hospital, Rue Hassan Ibn Nouaman, 3100, Kairouan, Tunisia.
| | - Sahbi Naouar
- Urology Department, Les Aghlabides Surgical Division, Ibn Jazzar Teaching Hospital, Rue Hassan Ibn Nouaman, 3100, Kairouan, Tunisia.
| | - Bilel Faidi
- Surgery Department, Les Aghlabides Surgical Division, Ibn Jazzar Teaching Hospital, Rue Hassan Ibn Nouaman, 3100, Kairouan, Tunisia.
| | - Rayen Lahouar
- Urology Department, Les Aghlabides Surgical Division, Ibn Jazzar Teaching Hospital, Rue Hassan Ibn Nouaman, 3100, Kairouan, Tunisia.
| | - Badreddine Ben Khalifa
- Urology Department, Les Aghlabides Surgical Division, Ibn Jazzar Teaching Hospital, Rue Hassan Ibn Nouaman, 3100, Kairouan, Tunisia.
| | - Rafik El Kamel
- Urology Department, Les Aghlabides Surgical Division, Ibn Jazzar Teaching Hospital, Rue Hassan Ibn Nouaman, 3100, Kairouan, Tunisia.
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Pereira KP, Rodrigues M, Roda D, Alves P. Adjuvant radiotherapy in the treatment of dedifferentiated liposarcoma of the spermatic cord: a rare entity. BMJ Case Rep 2021; 14:e238430. [PMID: 33419753 PMCID: PMC7798654 DOI: 10.1136/bcr-2020-238430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2020] [Indexed: 01/11/2023] Open
Abstract
Dedifferentiated liposarcoma (DDL) of the spermatic cord is a very rare entity in which management is remarkably controversial due to scarce literature. Although the actual standard of care is surgery via radical inguinal orchiectomy, adjuvant therapies like radiotherapy have demonstrated improved local control, particularly in cases with higher risk for local recurrence and worse prognosis. The role of adjuvant chemotherapy remains questionable in this subset of patients. On literature review, the most important prognostic factors for survival outcomes were surgical margin status, histological grade and the presence of metastases prior to the initial surgery. In this report, we discuss the case of a 59-year-old man with DDL of the spermatic cord that was treated with surgery followed by adjuvant radiotherapy. We also provide a comprehensive literature review about the management of this entity.
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Affiliation(s)
- Kayla Pires Pereira
- Radiotherapy Department, Francisco Gentil Portuguese Institute for Oncology of Coimbra, Coimbra, Portugal
| | - Mónica Rodrigues
- Radiotherapy Department, Francisco Gentil Portuguese Institute for Oncology of Coimbra, Coimbra, Portugal
| | - Domingos Roda
- Radiotherapy Department, Francisco Gentil Portuguese Institute for Oncology of Coimbra, Coimbra, Portugal
| | - Paula Alves
- Radiotherapy Department, Francisco Gentil Portuguese Institute for Oncology of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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11
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Liposarcoma of the spermatic cord presenting as an inguinal hernia. Int J Surg Case Rep 2020; 76:274-277. [PMID: 33059204 PMCID: PMC7566205 DOI: 10.1016/j.ijscr.2020.09.195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Dedifferentiated liposarcoma is a rare, highly malignant, rapidly recurring tumor. When found in the spermatic cord, this tumor may deceptively present as an inguinal hernia, and due to its rarity, may not be readily identified. PRESENTATION OF CASE We report a case of a 46-year old man with dedifferentiated liposarcoma presenting as a slow-growing right inguinal bulge. His surgical management included ipsilateral orchiectomy and excision with wide margins. He received adjuvant focused radiation therapy. CONCLUSION Liposarcoma of the Spermatic Cord is a rare and highly malignant tumor that rapidly recurs. Therefore, a high degree of suspicion, regular surveillance and imaging are justified.
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12
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[Rare histopathological finding with a scrotal hernia]. Chirurg 2020; 91:970-973. [PMID: 32776250 DOI: 10.1007/s00104-020-01259-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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13
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Seelig MH, Winkels R, Wiese M, Weyhe D. Spermatic cord liposarcomas incidentally found during hernia surgery: is histology of any lipoma mandatory? A review of the literature. Acta Chir Belg 2020; 120:79-84. [PMID: 31690184 DOI: 10.1080/00015458.2019.1689645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose: Liposarcomas found incidentally during open or laparoscopic inguinal hernia surgery are extremely rare. It is unclear, whether any adipose tissue being removed during inguinal hernia surgery must be sent for histology due to the potential risk of liposarcoma of the spermatic cord. This study aims to evaluate the frequency of liposarcomas incidentally found in the inguinal canal during hernia surgery and tries to derive evidence-based recommendations regarding the optimal management of any fatty tissue found in the inguinal canal.Methods: A literature review of the PubMed/Medline electronic databases between January 1980 and January 2019 was performed using the search terms 'inguinal hernia' and 'liposarcoma'. There was only one study available on this topic. Therefore, an additional literature review was performed analyzing all reports on patients with incidentally detected liposarcomas of the spermatic cord in the inguinal canal during hernia surgery.Results: There was only one retrospective study evaluating the frequency of inguinal liposarcoma found at hernia operations with a frequency of less than 0.1%. There were 18 cases of spermatic cord liposarcomas that were truly found incidentally during operation for an unsuspected symptomatic or incarcerated inguinal hernia. These included 16 case reports with a total of 18 patients and 19 liposarcomas. All patients were male with a median age of 62.5 years (range: 24-86 years) years. Median size of liposarcoma was 10.5 cm (range: 3-30 cm). In seven patients, the inguinal liposarcoma was an extension of a retroperitoneal sarcoma. Treatment consisted of radical orchidectomy during the primary operation in 12 patients. Three out of the seven patients with retroperitoneal extension of the tumor underwent a secondary operation with complete resection of the tumor.Conclusions: Currently, there is no evidence-based recommendation available regarding the management of lipomas detected during open or laparoscopic inguinal hernia surgery. Due to the extremely low risk of the presence of a liposarcoma, routine histologic examination cannot be recommended unless the diameter exceeds 10 cm.
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Affiliation(s)
- Matthias H. Seelig
- Department of General-, Visceral-, Thoracic- and Vascular Surgery, Kliniken Frankfurt-Main-Taunus, Bad Soden Am Taunus, Germany
| | - Raphael Winkels
- Department of General-, Visceral-, Thoracic- and Vascular Surgery, Kliniken Frankfurt-Main-Taunus, Bad Soden Am Taunus, Germany
| | | | - Dirk Weyhe
- Department for Human Medicine, Pius Hospital, Medical Campus University of Oldenburg, University Hospital for Visceral Surgery, Oldenburg, Germany
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Mouden K, Wakrim S, Semmar A. Paratesticular liposarcoma: a case report. Pan Afr Med J 2019; 33:282. [PMID: 31692859 PMCID: PMC6815510 DOI: 10.11604/pamj.2019.33.282.19545] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 07/15/2019] [Indexed: 12/15/2022] Open
Abstract
Paratesticular liposarcomas (PLS) is a very uncommon pathology type of paratesticular sarcomas, with less 200 similar cases reported to date in the English literature. There are a few cases regarding giant paratesticular liposarcoma measuring over 10 cm. We present an unusual case with a giant well differentiated PLS of the left testis extended to the pelvic cavity. We report the case of a 55-year-old man who presented with large left groin mass. The patient underwent left orchiectomy following a cure of a scrotal hernia. Histological and immunohistochemical findings were suggestive of a well-differentiated liposarcoma of spermatic cord. The surgical margins were positive. Metastatic work-up, which included CT of the thorax, abdomen and pelvis, did not reveal any distant metastasis in thorax but there is a left pathological external iliac lymph nodes and a left lateroplevic lipomatous mass extended to the iliac fossa and left parietocolic gutter up to the umbilicus measuring 15x7x17 cm. Our patient refused treatment. A review of the literature revealed that there are fewer cases of giant well differentiated paratesticular liposarcoma extended to the pelvic cavity were reported. This study focuses on the clinical characteristics and treatment of this rare type of tumours.
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Affiliation(s)
- Karima Mouden
- Department of Radiation Oncology, National Oncology Institute, Rabat, Morocco
| | - Soukaina Wakrim
- Department of Radiology, Ibn Zohr University, Faculty of Medicine and Pharmacy, Agadir, Morocco
| | - Afaf Semmar
- Department of Radiation Oncology, National Oncology Institute, Rabat, Morocco
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Ochi A, Toki S, Vanichakarn D, Suzuki K, Kitagawa Y, Abe H. Laparoscopic-assisted surgery for liposarcoma of the spermatic cord extending to the retroperitoneal cavity through the internal inguinal ring. IJU Case Rep 2019; 2:253-256. [PMID: 32743428 PMCID: PMC7292137 DOI: 10.1002/iju5.12084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 05/08/2019] [Indexed: 12/19/2022] Open
Abstract
Introduction Liposarcoma of the spermatic cord is a rare disease, reportedly treated with radical high orchiectomy. However, laparoscopic-assisted surgery for spermatic cord liposarcoma extending to the retroperitoneal cavity through the internal inguinal ring has not yet been reported. Case presentation A 78-year-old man had a spermatic cord tumor that extended to the retroperitoneal cavity through the internal inguinal ring and invaded the abdominal wall muscles. We performed laparoscopic-assisted surgery and successfully separated the tumor from the contiguous organs and vessels. The tumor was resected en bloc with abdominal wall muscles, and a muscular defect was repaired with a left tensor fascia lata muscle flap. Pathological analysis revealed a well-differentiated liposarcoma with negative surgical margins. There was no recurrence at 1 year post-surgery. Conclusion Laparoscopic-assisted surgery is a feasible and minimally invasive procedure for treating liposarcoma of the spermatic cord extending to the retroperitoneal cavity through the internal inguinal ring.
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Affiliation(s)
- Atsuhiko Ochi
- Department of Urology Kameda Medical Center Kamogawa Chiba Japan
| | - Sari Toki
- Department of Urology Kameda Medical Center Kamogawa Chiba Japan
| | | | - Koichiro Suzuki
- Department of Urology Kameda Medical Center Kamogawa Chiba Japan
| | - Yasuhide Kitagawa
- Department of Urology Komatsu Municipal Hospital Komatsu Ishikawa Japan
| | - Hirokazu Abe
- Department of Urology Kameda Medical Center Kamogawa Chiba Japan
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16
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Ayari Y, Sellami A, Boussaffa H, Zehani A, Ben Rhouma S, Nouira Y. About a case of paratesticular myxoid liposarcoma. Urol Case Rep 2018; 21:27-28. [PMID: 30155408 PMCID: PMC6111029 DOI: 10.1016/j.eucr.2018.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 08/11/2018] [Accepted: 08/15/2018] [Indexed: 11/29/2022] Open
Abstract
Paratesticular liposarcomas are relatively common sarcomas in the paratesticular region, however, the myxoid variant is considered very rare. Due to the infrequency of this malignant disease, no standard treatment would be available. Multiple treatments have reported in literature with different results. Herein, we presented a case of paratesticular myxoid liposarcoma in a 67-year-old man originating from the right paratesticular soft tissue.
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Affiliation(s)
- Yassine Ayari
- Department of Urology, La Rabta University Hospital, Tunisia
| | - Ahmed Sellami
- Department of Urology, La Rabta University Hospital, Tunisia
| | - Hamza Boussaffa
- Department of Urology, La Rabta University Hospital, Tunisia
| | - Alia Zehani
- Department of Anatomopathology, La Rabta University Hospital, Tunisia
| | - Sami Ben Rhouma
- Department of Urology, La Rabta University Hospital, Tunisia
| | - Yassine Nouira
- Department of Urology, La Rabta University Hospital, Tunisia
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Liposarcoma in the Inguinal Canal: Challenges in Preoperative Diagnosis and Importance of Routine Pathological Examination of "Hernia Sacs". Case Rep Pathol 2018; 2018:5929626. [PMID: 30258663 PMCID: PMC6146670 DOI: 10.1155/2018/5929626] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 08/09/2018] [Accepted: 08/28/2018] [Indexed: 11/18/2022] Open
Abstract
Liposarcoma is the most common histologic subtype of soft tissue sarcoma in the retroperitoneum. The distinction of primary cord liposarcomas, which arise in and are confined to the inguinal canal, from inguinoscrotal extension of a retroperitoneal tumor is mandatory. Both can be found incidentally in inguinal hernia sac specimens. Preoperative diagnosis is essential for adequate surgery with clear margins. We present a clinicopathological correlation of two men with slowly growing right para-testicular masses diagnosed as inguinal hernias. Pathological examination revealed well-differentiated lipoma-like liposarcoma and well-differentiated liposarcoma mixed type (lipoma-like and sclerosing types), respectively. The first tumor was considered a primary cord liposarcoma with no recurrence on follow-up. The second tumor showed an unusual growth pattern of discontinuous nodules that gave the false impression of complete resection. This growth pattern may explain why inguinal liposarcomas have a high recurrence rate despite apparently negative surgical margins. A follow-up CT scan exposed a fatty tumor in the retroperitoneum of the second patient. Careful interpretation of imaging studies in patients with fatty inguinal masses is mandatory to rule out a retroperitoneal or intraperitoneal component. Although the two cases herein discussed represent less than 0.1% of the total inguinal hernia sacs examined over the past five years in our pathology department, we recommend routine examination of all "mass-containing" hernia sacs as missing the diagnosis of liposarcoma can lead to substantial morbidity and mortality.
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Abstract
PURPOSE OF REVIEW Spermatic cord tumors (SCT) are very rare. The present review discusses the most recent literature regarding clinical presentation, pathological characteristics, diagnosis, and management of SCT. RECENT FINDINGS Although the majority of SCT are benign, when malignant almost all SCT are sarcomas. Liposarcomas are the most common; whereas rhabdomyosarcomas recorded the highest tendency of develop distant metastases. The clinical presentation is usually a unilateral solid slow-growing mass at the level of the inguinal canal and of the scrotum. Surgical excision represents the most common used treatment, and considering the risk in developing local recurrence, radical inguinal orchiectomy and resection of the tumor with negative microscopic surgical margins is mandatory. Adjuvant therapies such as radiotherapy and chemotherapy have been suggested in selected patients, but clear data to demonstrate any improvement in survival are not available. SUMMARY SCT are rare tumors with high risk of misdiagnosis or mistreatment. The majority are benign, but when malignant almost all are sarcomas. A surgical excision is the treatment of choice; however, no clear data exists documenting the efficacy of a multimodal treatment in reducing high local recurrence rates after surgery.
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Li Z, Zhou L, Zhao L, Chen P, Liu Y, Ding Y, Sun S, Yang S, Lai Y. Giant paratesticular liposarcoma: A case report and review of the literature. Mol Clin Oncol 2018; 8:613-616. [PMID: 29556392 PMCID: PMC5844082 DOI: 10.3892/mco.2018.1577] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 12/28/2017] [Indexed: 02/05/2023] Open
Abstract
Paratesticular liposarcoma is an infrequent tumor characterized by a growing, painless, inguinal or scrotal mass. Only about 200 cases have been reported as of yet in literature, however there are a few cases regarding giant paratesticular liposarcoma measuring over 10 cm. The disease may be commonly misdiagnosed prior to operation. Improper treatment tends to lead to local recurrence and distant metastasis. The current report presents a case of a 51-year-old patient with a large, painless right scrotum. Magnetic resonance imaging revealed a 7.8×5.8×10.4 cm nonhomogeneous space-occupying lesion of the right testis, which was firstly diagnosed as a spermatocytoma. Following this, a radical orchiectomy of the right testis was performed, however, it appeared to be a dedifferentiated liposarcoma, following histopathological examination and immunohistochemistry. Due to the large size of the tumor, it is significant to report the characteristics, diagnosis and treatment of the similar cases. The current study additionally presents a supplementary review of previously published cases in literature and focuses on discussion regarding the clinical characteristics, diagnosis, histopathology and immunohistochemical features and treatment of this disease.
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Affiliation(s)
- Zuwei Li
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen 518036, P.R. China
- Shantou University Medical College, Shantou, Guangdong 515041, P.R. China
| | - Liang Zhou
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen 518036, P.R. China
- Department of Urology, Guangzhou Medical University, Guangzhou, Guangdong 510006, P.R. China
| | - Liwen Zhao
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen 518036, P.R. China
| | - Peijie Chen
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen 518036, P.R. China
- Shantou University Medical College, Shantou, Guangdong 515041, P.R. China
| | - Yifeng Liu
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen 518036, P.R. China
| | - Yu Ding
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen 518036, P.R. China
| | - Shuolei Sun
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen 518036, P.R. China
| | - Shangqi Yang
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen 518036, P.R. China
| | - Yongqing Lai
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen 518036, P.R. China
- Correspondence to: Professor Yongqing Lai, Department of Urology, Peking University Shenzhen Hospital, 1120 Lianhua Road, Shenzhen 518036, P.R. China, E-mail:
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Noh D, Choi W, Son W, Lee M, Park S, Lee K. Liposarcoma of the spermatic cord in a Toy Poodle. J Vet Med Sci 2017; 79:2026-2029. [PMID: 29142149 PMCID: PMC5745184 DOI: 10.1292/jvms.17-0357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Liposarcoma of the spermatic cord is extremely rare in dogs and humans. This report describes the clinical signs, typical diagnostic imaging including ultrasound and computed tomography, and treatment of a liposarcoma of the spermatic cord of a Toy Poodle confirmed by histological examination after a surgical procedure. This case highlights the importance of preoperative diagnostic imaging and histopathological examination in dogs with an inguinal or scrotal mass.
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Affiliation(s)
- Daji Noh
- College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Korea
| | - Wooson Choi
- Two Man Veterinary Hospital, Daegu 42770, Korea
| | - Woochan Son
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Manhee Lee
- College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Korea
| | - Seungchun Park
- College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Korea
| | - Kija Lee
- College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Korea
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Thomas KL, Gonzalez RJ, Henderson-Jackson E, Caracciolo JT. Paratesticular Liposarcoma Masquerading as an Inguinal Hernia. Urology 2017; 113:e5-e6. [PMID: 29203187 DOI: 10.1016/j.urology.2017.11.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/20/2017] [Accepted: 11/21/2017] [Indexed: 11/28/2022]
Abstract
A man with left scrotal swelling felt to represent inguinal hernia underwent computed tomography scan for reported bleeding after prostate biopsy. Computed tomography scan revealed a 15-cm extratesticular left scrotal mass containing both fat and soft tissue components, raising concern for dedifferentiated liposarcoma. At surgery and pathology, the mass was separate from the left testis, epididymis, and spermatic cord. Histopathologic findings were consistent with paratesticular dedifferentiated liposarcoma.
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Affiliation(s)
- Kerry L Thomas
- Department of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, Tampa, FL.
| | - Ricardo J Gonzalez
- Department of Sarcoma and Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL
| | | | - Jamie T Caracciolo
- Department of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, Tampa, FL
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Andersen MFB, Fode M, Pilt AP, Azawi NHM. Liposarcoma in the spermatic cord presenting as an inguinal swelling. Transl Androl Urol 2017; 6:978-980. [PMID: 29184799 PMCID: PMC5673813 DOI: 10.21037/tau.2017.08.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Liposarcoma in the spermatic cord is a rare condition with an incidence of 1 per 2.5 million. The condition can present as paratesticular pain and a quick diagnosis is important in order to ensure proper treatment and to improve the prognosis. We describe a case of a 69-year-old man who suffered from long-lasting swelling in the inguinal area and experienced increasing pain through a period of 2 weeks. Due to increasing pain and fast growing swelling, an exploration of the inguinal area was performed and peroperatively a tumour in the spermatic cord was found. Subsequent histological examination revealed a de-differentiated liposarcoma.
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Affiliation(s)
| | - Mikkel Fode
- Deptartment of Urology, Zealand's Hospital University Roskilde, Roskilde, Denmark
| | - Anette Pedersen Pilt
- Department of Pathology, Zealand's Hospital University Roskilde, Roskilde, Denmark
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Gregorio MD, D'Hondt L, Lorge F, Nollevaux MC. Liposarcoma of the Spermatic Cord: An Infrequent Pathology. Case Rep Oncol 2017; 10:136-142. [PMID: 28203177 PMCID: PMC5301103 DOI: 10.1159/000455900] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 01/06/2017] [Indexed: 12/19/2022] Open
Abstract
Objective To describe a rare pathology, the liposarcoma of the spermatic cord (LSC), and discuss its diagnosis and treatment. Materials and Methods We report a case of well-differentiated LSC in a 61-year-old man. The main complaint was painless enlargement in the right inguinoscrotal area that appeared 6 months prior to presentation. Ultrasonography showed a heterogeneous and hyperechogenic mass of the right spermatic cord that was highly suspicious of malignancy. Computed tomography confirmed a heterogeneous supratesticular mass. The mass was surgically removed. Results Pathological examination showed a well-differentiated LSC. The patient did not receive any additional treatment. The follow-up did not present complications or further symptoms and, at present, the patient is in complete remission. Conclusion LCSs are a very rare entity. The diagnosis is difficult and often mistaken with common scrotal swelling associated with a hernia, hydrocele, or other tumour. Treatment should include complete surgical excision, usually by radical inguinal orchiectomy. A long follow-up period is necessary.
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[A CASE OF WELL-DIFFERENTIATED LIPOSARCOMA IN THE RIGHT SCROTUM, DIAGNOSED AFTER LOCAL TUMOR EXCISION]. Nihon Hinyokika Gakkai Zasshi 2017; 108:220-224. [PMID: 30333446 DOI: 10.5980/jpnjurol.108.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A 71-year-old male was referred to our hospital with right scrotal swelling. The ultrasonography and magnetic resonance imaging revealed a 6.5 cm mass adjacent to the right testicle. Under the preoperative diagnosis of benign intrascrotal lipoma, local tumor excision through scrotal skin incision was performed. The histopathological examination revealed atypical lipomatous tumor/well-differentiated liposarcoma. With the evidence of malignancy, two-stage surgery was mandatory. Thus, radical orchiectomy with high cord ligation and wide excision of surrounding soft tissue structures through inguinal skin incision was performed. However, there were no tumor cells remaining in the resected samples. Neither adjuvant radiation therapy nor chemotherapy has been performed since contrast computed tomography showed no evidence of metastasis. He is free of disease at 1 year postoperatively.
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Verghese M, Hwang J. Specific Surgical Topics: A Multidisciplinary Management of Paratesticular Sarcomas in Adults. Sarcoma 2017. [DOI: 10.1007/978-3-319-43121-5_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Rizer M, Singer AD, Edgar M, Jose J, Subhawong TK. The histological variants of liposarcoma: predictive MRI findings with prognostic implications, management, follow-up, and differential diagnosis. Skeletal Radiol 2016; 45:1193-204. [PMID: 27209201 DOI: 10.1007/s00256-016-2409-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 05/01/2016] [Accepted: 05/05/2016] [Indexed: 02/07/2023]
Abstract
Liposarcoma is the single most common soft tissue sarcoma accounting for up to 35 % of sarcomas. It represents a histologically diverse group of soft tissue tumors that demonstrate a wide range of imaging appearances with varied behavior patterns. Correspondingly, more aggressive histological subtypes often require management that includes a combination of surgery, chemotherapy, and radiation therapy. Distinguishing among liposarcoma subtypes has important therapeutic and prognostic implications. In this manuscript, we review the liposarcoma subtypes and their histologic and MRI findings, prognostic implications, and differential diagnostic considerations.
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Affiliation(s)
- Magda Rizer
- Department of Radiology, Mount Sinai Medical Center, Miami Beach, FL, USA.
| | - Adam D Singer
- Department of Radiology and Imaging Sciences, Section of Musculoskeletal Imaging, Emory Healthcare, Atlanta, GA, USA
| | - Mark Edgar
- Bone and Soft Tissue Pathology, Department of Pathology, Emory Healthcare, Atlanta, GA, USA
| | - Jean Jose
- Section of Musculoskeletal Imaging, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ty K Subhawong
- Section of Musculoskeletal Imaging, Miller School of Medicine, University of Miami, Miami, FL, USA
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Abstract
Paratesticular liposarcoma is a rare condition characterized by a growing, painless inguinal, or scrotal mass. To our knowledge, less than 200 cases worldwide are reported thus far. It is characterized by slow growth and can reach large dimensions at diagnosis. Paratesticular well-differentiated liposarcoma has a prolonged clinical course with recurrences in more than half the cases, sometimes late. Regardless of tumor size, radical orchidectomy with free surgical margins is recommended in order to avoid recurrence. When there is tumor recurrence, reoperation is the treatment of choice because radio- and chemotherapy have yet to be well established in these cases. There is a low risk of metastasis. Overall prognosis is good. Adjuvant therapies, represented by radio- and chemotherapy, have a controversial role in the literature due to the rarity of the disease. In this article, we present review of the literature and case discussion of paratesticular liposarcoma with focus on diagnosis, treatment and follow-up.
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Sambel M, Demirbas M, Yalcin O, Erdogan A, Oner S, Kilic M, Aydos M. Liposarcoma of the spermatic cord: A case report. Can Urol Assoc J 2015; 9:E527-30. [PMID: 26279732 DOI: 10.5489/cuaj.2827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Spermatic cord liposarcoma is very rare and characterized by a painless inguinal or scrotal mass. This is a case report of a 66-year-old man presenting with a mass in his left scrotum. Inguinal orchiectomy was performed and the histopathological examination revealed a liposarcoma of the spermatic cord.
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Affiliation(s)
- Murat Sambel
- Sevket Yilmaz Education and Research Hospital, Department of Urology, Bursa, Turkey
| | - Murat Demirbas
- Sevket Yilmaz Education and Research Hospital, Department of Urology, Bursa, Turkey
| | - Omer Yalcin
- Sevket Yilmaz Education and Research Hospital, Department of Urology and Pathology, Bursa, Turkey
| | - Abdullah Erdogan
- Sevket Yilmaz Education and Research Hospital, Department of Urology, Bursa, Turkey
| | - Sedat Oner
- Sevket Yilmaz Education and Research Hospital, Department of Urology, Bursa, Turkey
| | - Metin Kilic
- Sevket Yilmaz Education and Research Hospital, Department of Urology, Bursa, Turkey
| | - Murat Aydos
- Sevket Yilmaz Education and Research Hospital, Department of Urology, Bursa, Turkey
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