Peyrí Rey E, Urban Ramón A, Martínez Fernández M, Sanmarti Da Silva B
Servicio de Urología, Hospital Comarcal de la Selva., Blanes, Girona.
Actas Urol Esp. 2003 May;27(5):383-6. doi: 10.1016/s0210-4806(03)72940-4.
Spermatic cord sarcomas are rare tumours. Dedifferentiated liposarcoma accounts for only 10% of all spermatic cord sarcomas. These are usually large-sized tumours histologically characterised for being well-differentiated liposarcomas with some high grade sarcoma areas. Volume, location, mass homogeneity as well as presence of pelvic and retroperitoneal adenopathies are reported by CT and ultrasound techniques. These are useful for post-treatment follow-up. This paper presents one spermatic cord, dedifferentiated liposarcoma from which lipomas from the same spermatic cord had been previously removed in three occasions. We believe this is a degeneration of the earlier resected lipoma. Management is by extended inguinal radical orchiectomy. Value of adjuvant radio- and chemotherapy is uncertain. Post-surgery local relapses are common, and haematogenous and pelvic nodes metastasis likely. Survival at 5 and 10 years is 75% and 63% respectively.
精索肉瘤是罕见肿瘤。去分化脂肪肉瘤仅占所有精索肉瘤的10%。这些通常是大尺寸肿瘤,组织学特征为高分化脂肪肉瘤伴一些高级别肉瘤区域。CT和超声技术可报告肿瘤的体积、位置、肿块均匀性以及盆腔和腹膜后淋巴结肿大情况。这些对治疗后随访很有用。本文报告1例精索去分化脂肪肉瘤,该患者此前曾3次切除同一精索的脂肪瘤。我们认为这是早期切除脂肪瘤的退变。治疗方法是扩大腹股沟根治性睾丸切除术。辅助放疗和化疗的价值尚不确定。术后局部复发常见,血行转移和盆腔淋巴结转移也很可能发生。5年和10年生存率分别为75%和63%。