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Case Report
A rare case of spermatic cord leiomyosarcoma
1 Cooper University Hospital, Camden, New Jersey, United States
2 Department of Pathology, Cooper University Hospital, Camden, New Jersey, United States
3 MD Anderson Cancer Center at Cooper, Cooper University Hospital, Camden, New Jersey, United States
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Justin M Tiongson
Cooper University Hospital, Camden, New Jersey,
United States
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Article ID: 100020Z15JT2021
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Tiongson JM, Patel PA, McFarland M, Tomaszewski JJ. A rare case of spermatic cord leiomyosarcoma. J Case Rep Images Urol 2021;6:100020Z15JT2021.ABSTRACT
Introduction: Spermatic cord leiomyosarcoma is a rare soft tissue malignancy of paratesticular origin. Clinically, this tumor presents as a firm, painless, and slowly enlarging intrascrotal mass. Initial diagnostic testing includes scrotal ultrasonography followed by computed tomography (CT) scan or magnetic resonance imaging (MRI). The conventional management of spermatic cord leiomyosarcoma involves radical inguinal orchiectomy with high ligation of the spermatic cord.
Case Report: A 48-year-old African American male presented with a painless mass in his right hemiscrotum for 8-months’ duration. Scrotal ultrasound revealed a right-sided, heterogenous extratesticular scrotal mass. The patient underwent radical inguinal orchiectomy with excision of the spermatic cord. Subsequent histopathologic testing revealed a malignant spindle cell neoplasm consistent with leiomyosarcoma with evidence of lymphovascular involvement of the testicular vein and positive surgical margins. Staging CT scans of the chest, abdomen, and pelvis were negative for metastatic disease. Postoperative radiotherapy was deferred, with the patient currently under surveillance for local recurrence.
Conclusion: Leiomyosarcoma of the spermatic cord is a rare malignancy that currently lacks a standardized treatment approach. While radical orchiectomy is considered the gold standard of treatment, more evidence is needed to optimize other treatment modalities.
Keywords: Case report, Leiomyosarcoma, Paratesticular, Spermatic cord
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Author Contributions
Justin M Tiongson - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Parth A Patel - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Miles McFarland - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Jeffrey J Tomaszewski - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Justin M Tiongson et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
