Paratesticular localization of burned out non-seminomatous germ cell tumor--NSGCT: a case report

Testicular cancer is broadly divided into seminoma and non-seminoma types for treatment planning because seminomas are more sensitive to radiation therapy. Non-seminomatous germ-cell testis tumors represent a majority of all testicular neoplasms and include yolk sac tumor, embryonal carcinoma, choriocarcinoma, teratoma and undifferentiated tumors. Malignant neoplasms account for approximately 25% of neoplasms of the paratesticular tissues and most of them are sarcomas. We report a case of completely undifferentiated germ cell tumor of spermatic cord and discuss its diagnosis.

Cavernous hemangioma of spermatic cord: report of a case with immunohistochemical study

We present a case of spermatic cord cavernous hemangioma. A 32-year-old man presented with a circumscribed, painless mass in the left side of the spermatic cord. An orchiectomy of the left testicle was performed. A 3 x 3 x 2.5-cm mass was present in the spermatic cord area. Histologic examination and immunohistochemical study showed a benign vascular tumor composed of vascular spaces of varying size. Although cavernous hemangioma can occur in any location, the spermatic cord is an extremely rare site, and, to our knowledge, only a few cases have been previously reported.

Malignant fibrous histiocytoma of the spermatic cord: report of two cases and review of the literature

Malignant fibrous histiocytoma (MFH) of the spermatic cord is rare, and most published cases are single case reports that emphasize clinical presentation and management. We describe in detail the histopathologic features of 2 cases of high-grade storiform-pleomorphic MFH arising in the spermatic cord. Both tumors occurred in elderly men, 65 years and 70 years, and were 4 cm (Case 1) and 5 cm (Case 2) in greatest dimension. The tumor mass in Case 1 was associated with satellite tumor nodules. At last follow-up, in Case 1 the patient died of metastasis, and in Case 2, the patient is alive and well 46 months after diagnosis. Review of the literature reveals 33 additional cases published in English (17 cases) or Japanese (16 cases) that include histologic description. Including the 2 cases in this report, most of the tumors occurred in older (than 50 years) patients (28 of 35 cases, 80%) and occurred as solitary masses that ranged in diameter from less than 1 cm to more than 20 cm. Nine patients presented with satellite tumor nodules. Twenty-nine (83%) tumors were of the storiform-pleomorphic type, with 3 giant cell type, 2 inflammatory type, and 1 myxoid type. These features do not differ significantly from MFH in other anatomic sites. Clinical follow-up is available in 33 cases (3-174 months; mean, 31.5 months). Twelve patients developed recurrence and metastasis; at least 4 patients died of the disease. Tumor size does not predict the clinical progression; however, patients with progressive tumors were commonly associated with satellite nodules at time of presentation, an indication of early local metastasis.

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.