Para-testicular Liposarcoma: An Update of the Literature | Chapter 01 | New Insights into Disease and Pathogen Research Vol. 4
Less than 200 cases of para-testicular
liposarcoma (PTL) have been reported. PTL may present with painless or painful
intra-scrotal or inguinoscrotal mass of long duration or recent onset but the
most common presentation is a painless mass. Para-testicular liposarcomas does
mimic various common intra-scrotal and inguinoscrotal masses, some of which
include: inguinal hernia, lipoma, fibroma, fibrosarcoma, leiomyoma,
leiomyosarcoma, rhabdomyosarcoma, various types of testicular tumours and other
non-common intra-scrotal lesions. The symptoms tend to be non-specific. PTLs
tend to be unilateral but bilateral cases have been reported. Radiology imaging
would define the features of the lesion. Fine needle aspiration cytology could
establish the diagnosis but the diagnosis tends to be established by pathology
examination of the excised specimen of the tumour which would show
spindled-tumoral cells with atypical features and mitotic activity and
lipoblasts. Immunohistochemistry staining studies of the tumour would exhibit
positive staining for MDM2, CDK4, S100 and STAT6. PTL is treated by
trans-inguinal radical orchidectomy ensuring complete excision of the tumour
with tumour-free excision margin plus adjuvant radiotherapy plus / minus
adjuvant chemotherapy for localized disease. For metastatic and advanced
lesions, radical trans-inguinal orchidectomy plus radiotherapy plus
chemotherapy should be undertaken. New chemotherapy options need to be
developed to effectively destroy para-testicular liposarcoma tumour cells. All
excised innocuous looking intra-scrotal masses that should be submitted for
histopathology examination in order not to misdiagnose PTL as benign lipoma.
Generally the prognosis of localized PTL tends to be good following radical
orchidectomy with complete excision of tumour.
Author(s) Details
Mr. Anthony Kodzo-Grey
Venyo MB ChB FRCS(Ed) FRCSI FGCS Urol. LLM
Department of Urology, North
Manchester General Hospital, Manchester, M8 5RB, United Kingdom.
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