Liposarcoma of the Spermatic Cord – Diagnostic and Therapeutic Issue

Autor: Dimitrije Jeremic, Tanja Lakic, Ivan Levakov, Sandra Trivunić Dajko, Dragan Grbic, Sasa Vojinov, Miloš Maletin
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Acta Clinica Croatica, Vol 60., Iss 1., Pp 50-53 (2021)
Acta Clinica Croatica
Acta clinica Croatica
Volume 60.
Issue 1.
ISSN: 1333-9451
0353-9466
Popis: Liposarcoma of the spermatic cord is a malignant tumor so rare that there are less than 200 cases reported in the literature worldwide. Liposarcoma is a malignancy which originates from fat tissue. Although only 3%-7% of all paratesticular sarcomas primarily arise from structures of the spermatic cord, clinical significance of these tumors must not be neglected because they are often preoperatively misdiagnosed. A 66-year-old male presented with a painless swelling on the left side of the scrotum. Local examination revealed a solid, smooth, limited mass of approximately 4x3 cm in the left side of the scrotum. Tumor markers were within the reference range. Ultrasound examination showed a solid, clearly limited non-homogeneous mass of 40x20 mm localized in the left spermatic cord. Magnetic resonance imaging showed an expansive mass measuring 60x85x60 mm in the left inguinoscrotal region without propagation into the abdominal cavity. Both testicles and epididymides appeared normal on magnetic resonance examination and no locoregional enlarged lymph nodes were seen. The patient was treated operatively with radical inguinal orchiectomy. In conclusion, liposarcomas of the spermatic cord are extremely rare neoplasms that clinically present as slow-growing, painless, palpable inguinal or scrotal masses. Radical orchiectomy with high ligation of the spermatic cord and wide excision of the surrounding soft tissues within the inguinal canal remains the gold standard treatment option. Recurrence of the disease is frequent even several years after primary therapy, therefore long-term follow-up is mandatory.
Liposarkom sjemenske vrpce je toliko rijedak maligni tumor da je do sada opisano manje od 200 slučajeva u literaturi. Liposarkom je malignitet koji vodi podrijetlo od masnog tkiva. Iako samo 3%-7% svih paratestikularnih sarkoma primarno potječe od struktura sjemene vrpce, kliničko značenje ovih tumora ne smije se zanemariti, jer ih se često prijeoperacijski pogrešno dijagnosticira. U radu je prikazan bolesnik u dobi od 66 godina s kliničkom slikom bezbolne tumefakcije hemiskrotuma s lijeve strane. Lokalni nalaz je ukazivao na solidnu, glatku, jasno ograničenu masu veličine oko 4x3 cm u lijevom hemiskrotumu. Vrijednosti tumorskih biljega bile su unutar referentnih vrijednosti. Na ultrazvučnom pregledu opisana je solidna, jasno ograničena nehomogena masa dimenzija 40x20 mm u lijevoj sjemenoj vrpci. Magnetska rezononacija abdomena i zdjelice pokazala je ekspanzivnu masu u lijevoj ingvinoskrotalnoj regiji veličine oko 60x85x60 mm bez znakova propagacije u abdominalnu šupljinu. Na magnetskoj rezonanciji testisi i epididimisi su imali normalan izgled i nisu uočeni uvećani lokoregionalni limfni čvorovi. Bolesnik je tretiran operativno, napravljena je radikalna orhiektomija ingvinalnim pristupom. U zaključku, liposarkomi sjemene vrpce su ekstremno rijetke neoplazme koje se klinički manifestiraju kao sporo rastuće, bezbolne, palpabilne ingvinalne ili skrotalne mase. Radikalna orhiektomija s visokim podvezivanjem sjemene vrpce i širokom ekscizijom okolnih mekih tkiva unutar ingvinalnog kanala predstavlja zlatni standard liječenja. Recidiv bolesti je čest, čak i nekoliko godina nakon primarnog liječenja te je dugačko razdoblje praćenja obvezatno.
Databáze: OpenAIRE
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