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2009, Number 2

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Rev Med Hosp Gen Mex 2009; 72 (2)

Intrascrotal sarcomas. Study of 13 cases

Rodríguez-Florido MA, Hernández-González M, Aguirre-García J, García-Gomar MG, Juárez-Santiago L, Torres-Aguilar M

Language: Spanish
References: 106
Page: 78-84
PDF size: 616.89 Kb.


ABSTRACT

Introduction: The intrascrotal sarcomas, paratesticular and testicular are not frequent malignant mesenchymal tumors of the male genitourinary tract. Objectives: To identify the intrascrotal sarcomas in the General Hospital of Mexico in a period of thirteen years. To classify the histological variety. To compare the results with those described in the literature. Material and methods: The search of intrascrotal sarcomas was carried out in the files of the Unit of Pathology of the General Hospital of Mexico from 1995 to 2007. They were classified according to histopathological parameters and immunohistochemical studies were performed for diagnostic confirmation in the cases that needed it. Results: Thirteen sarcomas, eigth rhabdomyosarcomas, three liposarcomas, one leiomyosarcoma and one mesenchymoma malignum were found. Four rhabdomyosarcomas, two liposarcomas and the mesenchymoma malignum were paratesticular. A rhabdomyosarcoma was originated in a germinal neoplasia and it was not possible to identify the anatomical origin in five sarcomas. Conclusions: The liposarcomas are paratesticular neoplasms and seemingly they do not have relation with germinal origin. The rhabdomyosarcoma can be paratesticular or be part of germinal neoplasia what determines a clinical different behavior as well as variation in the treatment, in some cases it is not possible to define the site of origin due to the lack of extensive sampling that allows the identification of residual testicular tissue.


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  2. Evans HL. Unusual gonadal stromal tumor of the testis. Case report with ultrastructural observations. Arch Pathol Lab Med. 1977; 101: 317-320.

  3. Dilworth JP, Farrow GM, Oesterling JE. Non-germ cell tumors of testis. Urology 1991; 37: 399-417.

  4. Honore LH, Sullivan LD. Intratesticular leiomyoma: A case report with discussion of differential diagnosis and histogenesis. J Urol 1975; 114: 631-635.

  5. LiVolsi VA, Schiff M. Myxoid neurofibroma of the testis. J Urol 1977; 118: 341-342.

  6. Nistal M, Paniagua R, Regadera J et al. Testicular capillary hemangioma. Br J Urol 1982; 54: 433.

  7. D’Esposito RF, Ferrato LR, Wogalter H. Hemangioma of the testis in an infant. J Urol 1976; 116: 677-678.

  8. Tada M, Takemura S, Takimoto Y et al. A case of cavernous hemangioma of the testis. Hinyokika Kiyo 1989; 35: 1969-1971.

  9. Mazal PR, Kratzik C, Kain R et al. Capillary hemangioma of the testis. J Clin Pathol 2000; 53: 641-642.

  10. Suriawinata A, Talerman A, Vapnek JM et al. Hemangioma of the testis: report of unusual occurrences of cavernous hemangioma in a fetus and capillary hemangioma in an older man. Ann Diagn Pathol 2001; 5: 80-83.

  11. Banks ER, Mills SE. Histiocytoid (epithelioid) hemangioma of the testis. The so-called vascular variant of «adenomatoid tumor». Am J Surg Pathol 1990; 14: 584-589.

  12. Mazal PR, Kratzik C, Kain R et al. Capillary hemangioma of the testis. J Clin Pathol 2000; 53: 641-642.

  13. Issa MM, Yagol R, Tsang D. Intraescrotal neurofibromas. Urology 1993; 41: 350-352.

  14. Zukerberg LR, Young RH. Primary testicular sarcoma: a report of two cases. Hum Pathol 1990; 21 (9): 932-935.

  15. Mathew T, Prabhakaran K. Osteosarcoma of the testis. Arch Pathol Lab Med 1981; 105: 38-39.

  16. Washecka RM, Mariani AJ, Zuna RE, Honda SA, Chong CD. Primary intratesticular sarcoma. Immunohistochemical ultrastructural and DNA flow cytometric study of three cases with a review of the literature. Cancer 1996; 77 (8): 1524-1528.

  17. Yachia D, Auslaender L. Primary leiomyosarcoma of the testis. J Urol 1989; 141: 955-966.

  18. Kneale BJ, Bishop NL, Britton JP. Kaposi’s sarcoma of the testis. Br J Urol 1993; 72: 116-117.

  19. Davis AE Jr. Rhabdomyosarcoma of the testicle. J Urol 1962; 87: 148-154.

  20. Alexander F. Pure testicular rhabdomyosarcoma. Br J Cancer 1968; 22: 498-501.

  21. Kumar PV, Khezri AA. Pure testicular rhabdomyosarcoma. Br J Urol 1987; 59: 282.

  22. Ravich L, Lerman PH, Drabkin JW et al. Pure testicular rhabdomyosarcoma. J Urol 1965; 94: 596-599.

  23. Fuzesi L, Rixen H, Kirschner-Hermanns R. Cytogenetic findings in a metastatizing primary testicular chondrosarcoma. Am J Surg Pathol 1993, 17: 738-742.

  24. Masera A, Ovack Z, Mikuz G. Angiosarcoma of the testis. Virchows Arch 1999, 434: 351-353.

  25. Chiaramonte RM. Leiomyoma of tunica albuginea of testis. Urology 1988; 31: 344-345.

  26. Aus G, Boiesen PT. Bilateral leiomyoma of the tunica albuginea. Case report. Scand J Urol Nephrol 1991; 25: 79-80.

  27. Levant B, Chetlin MA. Neurofibroma of the tunica albuginea testis. J Urol 1948; 59: 1187-1189.

  28. Srigley JR, Hartwick RWJ. Tumors and cyst of the paratesticular region. Pathol Annu 1990; 25 (Pt 2): 51-108.

  29. Hata R, Iizumi T, Yazaki T et al. A case of primary bilateral epididymal leiomyoma. Hinyokika Kiyo 1989; 35: 1247-1249.

  30. Mathew T. Angiofibroma of the epididymis. Pathology 1981; 13: 625-630.

  31. Sarma DP, Weilbaecher TG. Leiomyoma of the spermatic cord. J Surg Oncol 1985; 28: 318-320.

  32. Belis JA, Post GJ, Rochman SC et al. Genitourinary leiomyomas. Urology 1979; 13: 424-429.

  33. Tanda F, Rocca PC, Bosincu L et al. Rhabdomyoma of the tunica vaginalis of the testis: A histologic, immunohistochemical, and ultrastructural study. Mod Pathol 1997; 10: 608-611.

  34. El-Badawi AA, Al-Ghorab MM. Tumors of the spertic cord: a review of the literature and a report of a case of Lymphangioma. J Urol 1965; 94: 445-450.

  35. Arda S, Senocak ME, Buyukpamukèu N et al. Lymphangioma of the spermatic cord and tunica vaginalis in children. Eur Urol 1992; 21: 253-255.

  36. Sanchez Chapado M, Aranda Lassa JM, Caballero Gomez M et al. Tumors of the spermatic cord: Report of a neurofibroma [Spanish]. Arch Esp Urol 1988; 41: 23-26.

  37. Chetty R. Epididymal cavernous haemangiomas. Histopathology 1993; 22: 396-398.

  38. Postius J, Manzano C, Concepcion T, Castro D, Gutierrez P, Banares F. Epididymal lymphangioma. J Urol 2000; 163: 550-551.

  39. Wehner MS, Humphreys JL, Sharkey FE. Epididymal rhabdomyoma; a report case, including histologic and immunohistochemical findings. Arch Pathol Lab Med 2000; 124: 1518-1519.

  40. Lilly MC, Arregui ME. Lipomas of the cord and round ligament. Ann Surg 2002, 235: 586-589.

  41. Mai KT, Yazdi HM, Collins JP. Vascular myxolipoma («angiomyxolipoma») of the spermatic cord. Am J Surg Pathol 1996; 20: 1145-1148.

  42. Bacchi CE, Schmidt RA, Brandao M, Scapulatempo R, Costa JC, Schmidt FC. Paraganglioma of the spermatic cord. Report of a case with immunohistochemical and ultrastructural studies. Arch Pathol Lab Med 1990; 114: 899-901.

  43. Eusebi V, Massarelli G. Phaeochromocytoma of the spermatic cord. Report of a case. J Pathol 1971; 105: 283-284.

  44. Folpe Al, Weiss SW. Paratesticular soft tissue neoplasm. Semin Diagn Pathol 2000; 17: 307-318.

  45. Sarma DP, Weilbaecher TG. Leiomyoma of the spermatic cord. J Surg Oncol 1985, 28: 318-320.

  46. Shim JW, Ro JY, Yang I, Lee KW, Chung SY. Solitary fibrous tumor: A case arising in the scrotum. J Urol Pathol 1999; 10: 229-238.

  47. Cummings OW, Ulbrigth TM, Young RH, Dei Tos AP, Fltcher CDM, Hull MT. Desmoplastic small round cell tumors of the paratesticular region: A report of six cases. Am J Surg Pathol 1997; 21: 219-225.

  48. Arlen M, Grabstald H, Whitmore WF Jr. Malignant tumors of the spermatic cord. Cancer 1969; 23: 525-532.

  49. Fisher C. Goldblum JR, Epstein JI, Montgomery E. Leiomyosarcoma of the paratesticular region: a clinicopathologic study. Am J Surg Pathol 2001; 25: 1143-1149.

  50. Kinjo M, Hokamura K, Tanaka K, Fujisawa Y, Hara s. Leiomyosarcoma of the spermatic cord. A case report and a brief review of literature. Acta Pathol Jpn 1986; 36: 929-934.

  51. Lin BT, Harvey DA, Medeiros LJ. Malignant fibrous histiocytoma of the spermatic cord: report of two cases and review of the literature. Mod Pathol 2002; 15: 59-65.

  52. Montgomery E, Fischer C. Paratesticular liposarcoma: A clinicopathologic study. Am J Surg Pathol 2003; 27: 40-47.

  53. Cavazzana AO, Schmidt D, Ninfa V et al. Spindle cell rhabdomyosarcoma: A prognostically favorable variant of rhabdomyosarcoma. Am J Surg Pathol 1991; 16: 229-235.

  54. Greco MA, Feiner HD, Theil KS et al. Testicular stromal tumor with myofilaments: Ultrastructural comparison with normal gonadal stroma. Hum Pathol 1984; 15: 238-243.

  55. Evans HL. Unusual gonadal stromal tumor of the testis. Case report with ultrastructural observations. Arch Pathol Lab Med. 1977; 101: 317-320.

  56. Dilworth JP, Farrow GM, Oesterling JE. Non-germ cell tumors of testis. Urology 1991; 37: 399-417.

  57. Honore LH, Sullivan LD. Intratesticular leiomyoma: A case report with discussion of differential diagnosis and histogenesis. J Urol 1975; 114: 631-635.

  58. LiVolsi VA, Schiff M. Myxoid neurofibroma of the testis. J Urol 1977; 118: 341-342.

  59. Nistal M, Paniagua R, Regadera J et al. Testicular capillary hemangioma. Br J Urol 1982; 54: 433.

  60. D’Esposito RF, Ferrato LR, Wogalter H. Hemangioma of the testis in an infant. J Urol 1976; 116: 677-678.

  61. Tada M, Takemura S, Takimoto Y et al. A case of cavernous hemangioma of the testis. Hinyokika Kiyo 1989; 35: 1969-1971.

  62. Mazal PR, Kratzik C, Kain R et al. Capillary hemangioma of the testis. J Clin Pathol 2000; 53: 641-642.

  63. Suriawinata A, Talerman A, Vapnek JM et al. Hemangioma of the testis: report of unusual occurrences of cavernous hemangioma in a fetus and capillary hemangioma in an older man. Ann Diagn Pathol 2001; 5: 80-83.

  64. Banks ER, Mills SE. Histiocytoid (epithelioid) hemangioma of the testis. The so-called vascular variant of «adenomatoid tumor». Am J Surg Pathol 1990; 14: 584-589.

  65. Mazal PR, Kratzik C, Kain R et al. Capillary hemangioma of the testis. J Clin Pathol 2000; 53: 641-642.

  66. Issa MM, Yagol R, Tsang D. Intraescrotal neurofibromas. Urology 1993; 41: 350-352.

  67. Zukerberg LR, Young RH. Primary testicular sarcoma: a report of two cases. Hum Pathol 1990; 21 (9): 932-935.

  68. Mathew T, Prabhakaran K. Osteosarcoma of the testis. Arch Pathol Lab Med 1981; 105: 38-39.

  69. Washecka RM, Mariani AJ, Zuna RE, Honda SA, Chong CD. Primary intratesticular sarcoma. Immunohistochemical ultrastructural and DNA flow cytometric study of three cases with a review of the literature. Cancer 1996; 77 (8): 1524-1528.

  70. Yachia D, Auslaender L. Primary leiomyosarcoma of the testis. J Urol 1989; 141: 955-966.

  71. Kneale BJ, Bishop NL, Britton JP. Kaposi’s sarcoma of the testis. Br J Urol 1993; 72: 116-117.

  72. Davis AE Jr. Rhabdomyosarcoma of the testicle. J Urol 1962; 87: 148-154.

  73. Alexander F. Pure testicular rhabdomyosarcoma. Br J Cancer 1968; 22: 498-501.

  74. Kumar PV, Khezri AA. Pure testicular rhabdomyosarcoma. Br J Urol 1987; 59: 282.

  75. Ravich L, Lerman PH, Drabkin JW et al. Pure testicular rhabdomyosarcoma. J Urol 1965; 94: 596-599.

  76. Fuzesi L, Rixen H, Kirschner-Hermanns R. Cytogenetic findings in a metastatizing primary testicular chondrosarcoma. Am J Surg Pathol 1993, 17: 738-742.

  77. Masera A, Ovack Z, Mikuz G. Angiosarcoma of the testis. Virchows Arch 1999, 434: 351-353.

  78. Chiaramonte RM. Leiomyoma of tunica albuginea of testis. Urology 1988; 31: 344-345.

  79. Aus G, Boiesen PT. Bilateral leiomyoma of the tunica albuginea. Case report. Scand J Urol Nephrol 1991; 25: 79-80.

  80. Levant B, Chetlin MA. Neurofibroma of the tunica albuginea testis. J Urol 1948; 59: 1187-1189.

  81. Srigley JR, Hartwick RWJ. Tumors and cyst of the paratesticular region. Pathol Annu 1990; 25 (Pt 2): 51-108.

  82. Hata R, Iizumi T, Yazaki T et al. A case of primary bilateral epididymal leiomyoma. Hinyokika Kiyo 1989; 35: 1247-1249.

  83. Mathew T. Angiofibroma of the epididymis. Pathology 1981; 13: 625-630.

  84. Sarma DP, Weilbaecher TG. Leiomyoma of the spermatic cord. J Surg Oncol 1985; 28: 318-320.

  85. Belis JA, Post GJ, Rochman SC et al. Genitourinary leiomyomas. Urology 1979; 13: 424-429.

  86. Tanda F, Rocca PC, Bosincu L et al. Rhabdomyoma of the tunica vaginalis of the testis: A histologic, immunohistochemical, and ultrastructural study. Mod Pathol 1997; 10: 608-611.

  87. El-Badawi AA, Al-Ghorab MM. Tumors of the spertic cord: a review of the literature and a report of a case of Lymphangioma. J Urol 1965; 94: 445-450.

  88. Arda S, Senocak ME, Buyukpamukèu N et al. Lymphangioma of the spermatic cord and tunica vaginalis in children. Eur Urol 1992; 21: 253-255.

  89. Sanchez Chapado M, Aranda Lassa JM, Caballero Gomez M et al. Tumors of the spermatic cord: Report of a neurofibroma [Spanish]. Arch Esp Urol 1988; 41: 23-26.

  90. Chetty R. Epididymal cavernous haemangiomas. Histopathology 1993; 22: 396-398.

  91. Postius J, Manzano C, Concepcion T, Castro D, Gutierrez P, Banares F. Epididymal lymphangioma. J Urol 2000; 163: 550-551.

  92. Wehner MS, Humphreys JL, Sharkey FE. Epididymal rhabdomyoma; a report case, including histologic and immunohistochemical findings. Arch Pathol Lab Med 2000; 124: 1518-1519.

  93. Lilly MC, Arregui ME. Lipomas of the cord and round ligament. Ann Surg 2002, 235: 586-589.

  94. Mai KT, Yazdi HM, Collins JP. Vascular myxolipoma («angiomyxolipoma») of the spermatic cord. Am J Surg Pathol 1996; 20: 1145-1148.

  95. Bacchi CE, Schmidt RA, Brandao M, Scapulatempo R, Costa JC, Schmidt FC. Paraganglioma of the spermatic cord. Report of a case with immunohistochemical and ultrastructural studies. Arch Pathol Lab Med 1990; 114: 899-901.

  96. Eusebi V, Massarelli G. Phaeochromocytoma of the spermatic cord. Report of a case. J Pathol 1971; 105: 283-284.

  97. Folpe Al, Weiss SW. Paratesticular soft tissue neoplasm. Semin Diagn Pathol 2000; 17: 307-318.

  98. Sarma DP, Weilbaecher TG. Leiomyoma of the spermatic cord. J Surg Oncol 1985, 28: 318-320.

  99. Shim JW, Ro JY, Yang I, Lee KW, Chung SY. Solitary fibrous tumor: A case arising in the scrotum. J Urol Pathol 1999; 10: 229-238.

  100. Cummings OW, Ulbrigth TM, Young RH, Dei Tos AP, Fltcher CDM, Hull MT. Desmoplastic small round cell tumors of the paratesticular region: A report of six cases. Am J Surg Pathol 1997; 21: 219-225.

  101. Arlen M, Grabstald H, Whitmore WF Jr. Malignant tumors of the spermatic cord. Cancer 1969; 23: 525-532.

  102. Fisher C. Goldblum JR, Epstein JI, Montgomery E. Leiomyosarcoma of the paratesticular region: a clinicopathologic study. Am J Surg Pathol 2001; 25: 1143-1149.

  103. Kinjo M, Hokamura K, Tanaka K, Fujisawa Y, Hara s. Leiomyosarcoma of the spermatic cord. A case report and a brief review of literature. Acta Pathol Jpn 1986; 36: 929-934.

  104. Lin BT, Harvey DA, Medeiros LJ. Malignant fibrous histiocytoma of the spermatic cord: report of two cases and review of the literature. Mod Pathol 2002; 15: 59-65.

  105. Montgomery E, Fischer C. Paratesticular liposarcoma: A clinicopathologic study. Am J Surg Pathol 2003; 27: 40-47.

  106. Cavazzana AO, Schmidt D, Ninfa V et al. Spindle cell rhabdomyosarcoma: A prognostically favorable variant of rhabdomyosarcoma. Am J Surg Pathol 1991; 16: 229-235.




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