Leiomyosarcoma of the spermatic cord: case report and literature review

Leiomyosarcoma of the spermatic cord is a rare entity. It can arise from any mesenchymal cell of its structure. It occurs mainly in elderly patients. It presents as a firm and painless intrascrotal mass. We present a case of a 30-year-old man with a 3-year history of a painless left-sided scrotal mass. Ultra-sound examination showed a scrotal mass. Further work-up revealed no distant metastasis before surgery. A left radical 1-block orchidectomy with epididymis and spermatic cord was performed. The final histopathologic examination showed a pattern of leiomyosarcoma of the spermatic cord. Considering the result of the histopathological examination, the Onco-logical Council did not recommend any additional surgery, but only watchful waiting. Almost 4 years of follow-up have passed without additional treatment. Primary scrotal leiomyosarcoma is an exceptional entity with only 100 cases reported in the literature. Due to its rarity, additional studies are needed to better define the optimal therapeutic management. A literature review and treatment strategy are discussed.