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|Year : 1989 | Volume
| Issue : 4 | Page : 235-6
Paratesticular myxoliposarcoma--(a case report).
NU Ranadive, PP Varty, GC Doshi, DM Gupte
N U Ranadive
Source of Support: None, Conflict of Interest: None
A rare case of paratesticular myxoliposarcoma spreading to the inguinal region forming satellite nodules, hence clinically mimicking a metastatising testicular malignancy is reported. Its prognostic factors are discussed.
Keywords: Case Report, Human, Liposarcoma, pathology,Male, Middle Age, Testicular Neoplasms, pathology,
|How to cite this article:|
Ranadive N U, Varty P P, Doshi G C, Gupte D M. Paratesticular myxoliposarcoma--(a case report). J Postgrad Med 1989;35:235
| :: Introduction|| |
Among the different variants of liposarcomas, myxoliposarcoma has a favourable prognosis. By and large, liposarcomas are sarcomatous tumours, well encapsulated and have distinct lobular pattern. Occasionally, small lobules may be separated from the main tumour mass and result in satellite nodules. The reported cases of paratesticular liposarcoma are very few,, and hence the present communication.
| :: Case report|| |
A 50 year old male presented with painful left inguinal swelling of one month's duration. He had undergone left herniorrhaphy 15 years back On physical examination he was found well built, moderately nourished with a spherical (8 cm diameter), immobile tender swelling in the left inguinal region. Another nontender, hard, non-transilluminant, intrascrotal swelling, growing gradually over a period of 6 months. was also noticed, of which the patient was not worried. Routine haematological arid urine investigations were within normal limits. The patient was explored with a provisional diagnosis of obstructed hernia and chronic haematocoele. On exploration, a well capsulated fleshy mass adhering to spermatic cord and extending into the scrotum was noticed, alongwith small nodules in the superficial inguinal region. An orchideetomy was performed alongwith the excision of intra-scrotal and inguinal masses, considering a possibility of metastatic testicular malignancy. The plane of cleavage could be achieved easily. The extratesticular tumour mass (800 gm) was lobulated, and yellowish white in colour with myxoid areas. 'The epididymis was replaced by the tumour [Fig, 1]. The discrete nodules (1 cm x 1 cm) had similar appearance.
On histological examination of the specimens, tumour cells showed signet ring cells alongwith spindle shaped cells interspersed in loose myxoid stroma. There were a few mitotic figures and presence of multinucleate giant cells. The oil red O' stain was carried out to confirm the diagnosis of liposarcoma. [Fig. 2].
| :: Discussion|| |
The intrascrotal sarcomas arise from the mesenchymal tissue of the spermatic cord, testicular tunicas or epididymis.2 In the present case the tumour was either arising from the spermatic cord or the epididymis. The observation of satellite nodules in the inguinal region alongwith discrete nodules adhering to the main mass are consistent with the behaviour of liposarcoma. A metastasic testicular tumour was suspected because of the previous hernia surgery. Myxoid liposarcomas account for 40-50% of all liposarcomas and the survival depends both on the histological appearance as well as their anatomical location., Out of paratesticular liposarcoma, 60% have 5 year survival rate; the myxoid variety has much favourable course. Though complete excision appears to be an adequate treatment, a close follow-up is essential, as a possibility of multicentric origin cannot be denied in the present case. An occurrence of visceral metastasis 10-15 years after the initial therapy was observed in myxoid variety which is consistent with the possibility of multicentricity of this tumour.
| :: References|| |
|1.||Enzinger, F. M. and Weiss, S. M.: Liposarcoma. In. "Soft Tissue Tumours", The, C. V. Mosby Company, London, 1983, pp. 242-280. |
|2.||Gerber, W. L.: Scrotal malignancies: the University of Iowa experience and a review of the literature. Urology, 26: 337-342, 1985. |
|3.||Mostofi, F. K. and Price, E. B.: Tumors of fatty tissue. In, "Tumors of the Male General System." Atlas of Tumor Pathology, second series, Fascicle 8, Editor: H. I. Firminger. Armed Forces Institute of Pathology, Washington D.C., 1973. pp. 166-167. |