Ebey Babe Nejib, Naouar Sahbi, Faidi Bilel, Lahouar Rayen, Ben Khalifa Badreddine, El Kamel Rafik
Urology Department, Les Aghlabides Surgical Division, Ibn Jazzar Teaching Hospital, Rue Hassan Ibn Nouaman, 3100, Kairouan, Tunisia.
Surgery Department, Les Aghlabides Surgical Division, Ibn Jazzar Teaching Hospital, Rue Hassan Ibn Nouaman, 3100, Kairouan, Tunisia.
Int J Surg Case Rep. 2021 Apr;81:105725. doi: 10.1016/j.ijscr.2021.105725. Epub 2021 Mar 6.
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.
精索脂肪肉瘤非常罕见,约占睾丸旁肉瘤的7%。它被认为是恶性程度最高的肿瘤之一。我们报告一例45岁男性精索脂肪肉瘤病例,该患者主诉右侧腹股沟阴囊区域渐进性无痛性肿胀。超声和计算机断层扫描结果与精索脂肪肉瘤相符。我们进行了右侧根治性睾丸切除术,并广泛切除肿块。组织学检查确诊并显示为多形性亚型。精索脂肪肉瘤治疗的主要方法是广泛切除并根治性睾丸切除术。预后的最重要因素是组织学亚型和手术切缘状态。对于局部复发高危病例应考虑辅助放疗。必须进行长期监测。精索脂肪肉瘤是一种罕见的睾丸旁肿瘤,应作为腹股沟阴囊肿块鉴别诊断的一部分。根治性腹股沟睾丸切除术并广泛切除软组织肿块和精索是实现最长局部和全身无病生存期的关键。