Arai Haruna, Sogabe Hirofumi, Morikawa Shinnosuke, Arai Osuke, Watanabe Ryuta, Ozawa Akira, Hida Akira I, Iseda Tokuhiro, Kohashi Kenichi, Oda Yoshinao
Department of Urology, Matsuyama Shimin Hospital, 2-6-5 Otemachi, Matsuyama, Ehime 7900067 Japan.
Department of Urology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime 7910295 Japan.
Int Cancer Conf J. 2024 Apr 30;13(3):301-305. doi: 10.1007/s13691-024-00682-6. eCollection 2024 Jul.
Dedifferentiated liposarcoma is a rare cancer with a poor prognosis. A 52-year-old man presented with a chief complaint of a mass in his left scrotum. He came with suspected testicular tumor, but all the measured tumor markers were negative. Imaging test showed approximately 2 cm diameter mass accompanied by calcification with some substantial components between the testis and epididymis. Left high testicular resection was performed. The tumor had no continuity between the testis and epididymis, and the spermatic cord transection was negative. Pathological findings showed well differentiated fatty component and a dedifferentiated component around the trabecular bone-like tissue. We observed dedifferentiated dysmorphic cells mixed with fatty droplets of unequal size. Immunostaining led to the diagnosis of dedifferentiated liposarcoma. No additional postoperative therapy was performed. The possibility of dedifferentiated liposarcoma should be kept in mind even if mass is confined to the scrotum and consisted of calcification. In the case of an intrascrotal calcified mass with malignant perspective, radical surgery is highly recommended.
去分化脂肪肉瘤是一种罕见的癌症，预后较差。一名52岁男性以左侧阴囊肿物为主诉前来就诊。他因疑似睾丸肿瘤前来，但其所有检测的肿瘤标志物均为阴性。影像学检查显示直径约2厘米的肿物，伴有钙化，睾丸和附睾之间有一些实性成分。进行了左侧高位睾丸切除术。肿瘤在睾丸和附睾之间没有连续性，精索横断检查为阴性。病理结果显示有分化良好的脂肪成分以及在小梁骨样组织周围的去分化成分。我们观察到去分化的异形细胞与大小不等的脂肪滴混合存在。免疫组化检查确诊为去分化脂肪肉瘤。术后未进行其他治疗。即使肿物局限于阴囊且由钙化构成，也应考虑到去分化脂肪肉瘤的可能性。对于具有恶性倾向的阴囊内钙化肿物，强烈推荐进行根治性手术。
