Matias Margarida, Carvalho Miguel, Xavier Luisa, Teixeira José Alberto
Department of Medical Oncology, Hospital Garcia de Orta, Almada, Portugal.
Department of Urology, Hospital Garcia de Orta, Almada, Portugal.
BMJ Case Rep. 2014 Aug 21;2014:bcr2014205808. doi: 10.1136/bcr-2014-205808.
Paratesticular sarcomas are rare and account for less than 1% of all adult sarcomas. Intrascrotal tumours can be testicular or paratesticular, paratesticular tumours being rarer (7-10%). Only 30% of paratesticular tumours are malignant and 90% of these are sarcomas. Histological subtypes include leiomyosarcoma, rhabdomyosarcoma, liposarcoma and undifferentiated high-grade pleomorphic sarcoma. Recurrence is frequent in this type of tumour and can occur years from initial diagnosis. These reports show two cases of paratesticular sarcoma with very distinct evolutions. The first case concerns a patient who presented with low-grade leiomyosarcoma with two local recurrences treated with surgery, and distance recurrence with cutaneous, subcutaneous, pulmonary and hepatic metastasis 30 years after surgery of the primary tumour. The second case reports of a patient who presented with high-grade myxoid liposarcoma with local and distance recurrence 3 years after surgery of the primary tumour, which progressed after chemotherapy; the patient died 7 months after diagnosis of recurrence.
睾丸旁肉瘤较为罕见,占所有成人肉瘤的比例不到1%。阴囊内肿瘤可为睾丸肿瘤或睾丸旁肿瘤,睾丸旁肿瘤更为少见(7% - 10%)。仅30%的睾丸旁肿瘤为恶性,其中90%为肉瘤。组织学亚型包括平滑肌肉瘤、横纹肌肉瘤、脂肪肉瘤和未分化高级别多形性肉瘤。这类肿瘤复发常见,可在初次诊断数年之后发生。这些报告展示了两例演变过程截然不同的睾丸旁肉瘤病例。第一例涉及一名患者,其表现为低级别平滑肌肉瘤,经历两次局部复发后接受手术治疗,在原发肿瘤手术后30年出现远处复发,伴有皮肤、皮下、肺和肝转移。第二例报告了一名患者,其表现为高级别黏液样脂肪肉瘤,在原发肿瘤手术后3年出现局部和远处复发,化疗后病情进展;患者在复发诊断后7个月死亡。