Spermatic cord leiomyosarcoma
Spermatic cord leiomyosarcomas are uncommon malignant paratesticular masses.
Accounts for ~10% of spermatic cord sarcomas. The average of a patient at presentation is 58 years old (although has been seen as young as 15 years old).
Patients may have left inguinal swelling (typically painless).
As with other leiomyosarcomas, they arise from smooth muscle (in this instance smooth muscle in the spermatic cord). On gross pathology they appear as firm, smooth masses, which may demonstrate some necrosis and hemorrhage.
Although imaging findings can contribute to a differential diagnosis, biopsy is usually needed for diagnosis.
Primary modality for evaluation
- increased vascularity on color Doppler
- more often in the scrotal part of the spermatic cord (lipoma more often at inguinal part)
- imaging features not defined
Treatment and prognosis
Treatment usually consists of transinguinal radical orchiectomy with adjuvant radiation therapy and chemotherapy.