PARATESTICULAR LEIOMYOSARCOMA: CASE REPORT

Paratesticular leiomyosarcoma (LMS) is a rare tumor; soft tissue sarcomas represent 1% of all neoplasms in adults. They are located in the extremities and retroperitoneal region. Leiomyosarcoma is one of the most common histological subtypes, which develop in the paratesticular region. The origins are usually in the intratesticular tubules, the epididymis, the spermatic cord, the dartos layer, and the scrotal skin.We present the case of a 54-year-old male patient who came to the outpatient oncological surgery clinic. Two years prior, he underwent excision of a right epididymal cyst with multiple septations and a right inguinal hernioplasty. One year prior, he reported nodular lesions in the right epididymis, which had increased in size. An imaging study was performed: a scrotal ultrasound, which revealed an extensive tumor mass that appeared to originate from the right epididymis. This solid, lobulated mass, with echogenic areas or calcifications, measured 8.6 x 5.8 cm and showed areas of central hypervascularization. This extensive mass compressed and displaced the testicle anteriorly and superiorly. Physical examination revealed a large right testicle with a 10 x 9 cm mass in diameter, of stony consistency but mobile, located in the right scrotal sac. A right radical orchiectomy and left superficial inguinal lymphadenectomy were performed. According to the results of the biopsy sample, histological findings were consistent with a paratesticular mesenchymal tumor with immunohistochemical markers positive for FNCLCC grade 1 leiomyosarcoma.