Blaiech Walid, Ben Othmen Mouna, Ouahchi Ines, Alaya Meriam, Belkacem Oussama, Hmida Wissem, Jaidane Mehdi
Department of Urology.
Department of Cytogenetic and Reproductive Biology, Farhat Hached University Teaching Hospital, Sousse, Tunisia.
Ann Med Surg (Lond). 2024 Mar 15;86(5):3103-3108. doi: 10.1097/MS9.0000000000001949. eCollection 2024 May.
Paratesticular liposarcoma (PTL) is a rare condition, with fewer than 200 cases reported worldwide. It is a malignant tumor that originates from fat tissue with high risk of recurrence. Herein, the authors present a contralateral recurrence of a treated PTL. To the best of the authors' knowledge, in the current literature, there are few cases reported with recurrent PTL.
The authors report the case of a 62-year-old man who presented with a rapidly growing painless right hemiscrotal swelling. Clinical and radiographic evidence suggested the presence of two paratesticular tumors. The patient underwent a radical orchidectomy with resection of the two tumors through an inguinal approach. The histologic examination revealed a sclerosing, well-differentiated liposarcoma. The decision of the multidisciplinary consultation meeting was not to do adjuvant treatment. A follow-up of 12 months showed recurrence of the contralateral scrotum revealed by an FDG-PET/scan.
PTL, a rare spermatic cord tumor, affects adults aged 50-60, often presenting with scrotal swelling. Diagnosis involves ultrasound, computed tomography, and magnetic resonance imaging. Surgical intervention, including radical orchiectomy and adjuvant radiotherapy, is common for management, while the role of chemotherapy is inconclusive. High-grade subtypes carry a higher recurrence risk.
PTL is often misdiagnosed preoperatively. It is typically managed through radical orchidectomy, which includes wide excision and high ligation to ensure free surgical margins and avoid recurrence. The role of adjuvant therapy remains debatable. Despite a generally favorable prognosis, long-term follow-up is crucial because of the elevated risk of recurrence.
睾丸旁脂肪肉瘤（PTL）是一种罕见疾病，全球报告的病例少于200例。它是一种起源于脂肪组织的恶性肿瘤，复发风险高。在此，作者报告了一例经治疗的PTL对侧复发病例。据作者所知，在当前文献中，复发性PTL的报道病例很少。
作者报告了一例62岁男性患者，其右侧阴囊无痛性肿胀迅速增大。临床和影像学证据提示存在两个睾丸旁肿瘤。患者通过腹股沟入路接受了根治性睾丸切除术及两个肿瘤的切除。组织学检查显示为硬化性、高分化脂肪肉瘤。多学科会诊会议决定不进行辅助治疗。12个月的随访显示，FDG-PET/扫描发现对侧阴囊复发。
PTL是一种罕见的精索肿瘤，影响50至60岁的成年人，常表现为阴囊肿胀。诊断包括超声、计算机断层扫描和磁共振成像。手术干预，包括根治性睾丸切除术和辅助放疗，是常见的治疗方法，而化疗的作用尚无定论。高级别亚型复发风险更高。
PTL术前常被误诊。通常通过根治性睾丸切除术进行治疗，包括广泛切除和高位结扎，以确保手术切缘阴性并避免复发。辅助治疗的作用仍有争议。尽管总体预后良好，但由于复发风险升高，长期随访至关重要。
