Management of Paratesticular Well Differentiated Liposarcoma (Atypical Lipomatous Tumour) without Adjuvant Therapy: Case Report

Öz

Less than 200 cases of para-testicular liposarcoma have been reported. Testicular liposarcoma 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. We present a 58-year-old male patient who presented with the complaint of painless swelling in the right hemiscrotum. Initially, a clinical diagnosis of testicular tumor was made; however, doppler ultrasonography of the scrotum showed paratesticular tumor. Right scrotal orchiectomy was performed and a diagnosis of liposarcoma was made. Histopathological studies confirmed the diagnosis of well-differentiated liposarcoma (atypical lipomatous tumor). No distant metastasis was evident in the whole-body PET-CT scan. Since adjuvant chemotherapy and radiotherapy in the treatment management of the disease is controversial, it was decided to follow up without adjuvant therapy after surgery.

Anahtar Kelimeler

• Paratesticular liposarcoma
• Atypical lipomatous tumor
• Radiotherapy
• Chemotherapy.

Kaynakça

1. 1. Arda N, Demiryont M. Liposarkom: 138 vakada histopatolojik, histokimyasal ve immunhistokimyasal çalışma. Turkish Journal of Pathology. 1995;11:32-6.
2. 2. Mack T, Purgina B. Updates in Pathology for Retroperitoneal Soft Tissue Sarcoma. Current Oncology. 2022;29(9):6400-18.
3. 3. Pănuş A, Meşină C, Pleşea IE, Drăgoescu PO, Turcitu N, Maria C, et al. Paratesticular liposarcoma of the spermatic cord: a case report and review of the literature. Rom J Morphol Embryol. 2015;56(03):1153-7.
4. 4. Palma PD, Barbazza R. Well‐differentiated liposarcoma of the paratesticular area: Report of a case with fine‐needle aspiration preoperative diagnosis and review of the literature. Diagnostic cytopathology. 1990;6(6):421-6.
5. 5. Vinayagam K, Hosamath V, Honnappa S, Rau AR. Paratesticular liposarcoma-masquerading as a testicular tumour. Journal of Clinical and Diagnostic Research: JCDR. 2014;8(2):165.
6. 6. Lokuhetty D, White V, Cree I. WHO Classification Of Tumours: Soft Tissue And Bone Tumours, ed 5. Lyon, France. International Agency for Research on Cancer. 2020.
7. 7. Russo P. Urologic sarcoma in adults: Memorial Sloan-Kettering Cancer Center experience based on a prospective database between 1982 and 1989. Urologic Clinics of North America. 1991;18(3):581-8.
8. 8. McCormick D, Mentzel T, Beham A, Fletcher CD. Dedifferentiated liposarcoma clinicopathologic analysis of 32 cases suggesting a better prognostic subgroup among pleomorphic sarcomas. The American journal of surgical pathology. 1994;18(12):1213-23.

9. 9. Bock S, Hoffmann DG, Jiang Y, Chen H, Il’yasova D. Increasing incidence of liposarcoma: a population-based study of national surveillance databases, 2001–2016. International journal of environmental research and public health. 2020;17(8):2710.
10. 10. Kooby DA, Antonescu CR, Brennan MF, Singer S. Atypical lipomatous tumor/well-differentiated liposarcoma of the extremity and trunk wall: importance of histological subtype with treatment recommendations. Annals of surgical oncology. 2004;11:78-84.
11. 11. Aksu G, Ağir H. The role of postoperative radiotherapy in treatment of soft tissue sarcomas. Turkish Journal of Oncology. 2007;22(2).
12. 12. Kamitani R, Matsumoto K, Takeda T, Mizuno R, Oya M. Optimal treatment strategy for paratesticular liposarcoma: retrospective analysis of 265 reported cases. International Journal of Clinical Oncology. 2020;25:2099-106.
13. 13. Huddart R, Patrikidou A, Hazell S. Rare tumors of the testis and paratesticular tissues. Textbook of uncommon cancer. 2017:97-121.
14. 14. Coleman J, Brennan MF, Alektiar K, Russo P. Adult spermatic cord sarcomas: management and results. Annals of Surgical Oncology. 2003;10:669-75.
15. 15. Le Fevre C, Waissi W, Chambrelant I, Noel G, Antoni D. A critical narrative review of radiotherapy for retroperitoneal soft tissue sarcoma. Chin Clin Oncol. 2020;9:79.
16. 16. Hinman F, Gibson TE. Tumors of the epididymis, spermatic cord and testicular tunics: a review of the literature and report of three new cases. Archives of Surgery. 1924;8(1):100-37.
17. 17. Alyousef H, Osman EM, Gomha MA. Paratesticular liposarcoma: a case report and review of the literature. Case Reports in Urology. 2013;2013.
18. 18. Song CH, Chai FY, Saukani MFM, Singh H, Jiffre D. Management and prevention of recurrent paratesticular liposarcoma. The Malaysian Journal of Medical Sciences: MJMS. 2013;20(4):95.
19. 19. Zheng Q-G, Sun Z-H, Chen J-J, Li J-C, Huang X-J. Paratesticular liposarcoma: Two case reports. World Journal of Clinical Cases. 2021;9(2):457.
20. 20. Manji GA, Schwartz GK. Managing liposarcomas: cutting through the fat. Journal of Oncology Practice. 2016;12(3):221-7.
21. 21. Ballo MT, Zagars GK, Pisters PW, Feig BW, Patel SR, Von Eschenbach AC. Spermatic cord sarcoma: outcome, patterns of failure and management. The Journal of urology. 2001;166(4):1306-10.
22. 22. Hazariwala R, Morris CG, Gilbert S, Algood C, Zlotecki RA. Radiotherapy for spermatic cord sarcoma. American journal of clinical oncology. 2013;36(4):392-4.
23. 23. Trovik LH, Ovrebo K, Almquist M, Haugland HK, Rissler P, Eide J, et al. Adjuvant radiotherapy in retroperitoneal sarcomas. A Scandinavian Sarcoma Group study of 97 patients. Acta Oncologica. 2014;53(9):1165-72.
24. 24. Yang JC, Chang AE, Baker AR, Sindelar WF, Danforth DN, Topalian SL, et al. Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. Journal of clinical oncology. 1998;16(1):197-203.
25. 25. Fagundes MA, Zietman AL, Althausen AF, Coen JJ, Shipley WU. The management of spermatic cord sarcoma. Cancer: Interdisciplinary International Journal of the American Cancer Society. 1996;77(9):1873-6.
26. 26. Keenan RA, Nic An Riogh AU, Stroiescu A, Fuentes A, Heneghan J, Cullen IM, et al. Paratesticular sarcomas: a case series and literature review. Therapeutic Advances in Urology. 2019;11:1756287218818029.
27. 27. Radaelli S, Desai A, Hodson J, Colombo C, Roberts K, Gourevitch D, et al. Prognostic factors and outcome of spermatic cord sarcoma. Annals of surgical oncology. 2014;21:3557-63.
28. 28. Mouden K, Wakrim S, Semmar A. Paratesticular liposarcoma: a case report. The Pan African Medical Journal. 2019;33.
29. 29. Ogbue OD, Haddad A, Daw H. Spermatic Cord Liposarcoma: A Case Report and Review of the Literature on the Role of Radiotherapy and Chemotherapy in Preventing Locoregional Recurrence. Cureus. 2021;13(11).
30. 30. Rizer M, Singer AD, Edgar M, Jose J, Subhawong TK. The histological variants of liposarcoma: predictive MRI findings with prognostic implications, management, follow-up, and differential diagnosis. Skeletal radiology. 2016;45:1193-204.