engleski

Epididymal leiomyosarcoma

Leiomyosarcoma is a malignant tumor of smooth muscle origin. Its presentation in epididymis is very uncommon and only 18 cases have been described to date. Herein, we present a case of epididymal leiomyosarcoma in a 59-year-old male patient. The patient presented with a scrotal mass located in the right epididymis. The patient underwent excision of the mass, which was submitted to histopathologic analysis. Gross examination revealed an oval, partly encapsulated tumor mass measuring 3x2x1.5 cm, with solid and whitish cut surface. Light microscopy examination revealed a tumor composed of spindle cells with cigar-shaped and blunt-ended nuclei showing variable atypia, arranged in short bundles and fascicles. There were 8 mitoses per 10 high-power fields. Foci of hemorrhage were also seen. Tumor cells were immunohistochemically positive for smooth muscle actin, desmin and vimentin. Proliferative index measured with Ki67 was up to 50%. A diagnosis of leiomyosarcoma of epididymis was established. The epididymis represents a rare location for leiomyosarcoma. Its histologic characteristics are the same as those found in other organs. The natural course of this tumor depends on its size, grade and evidence of nodal or distant metastasis. The treatment of choice is high inguinal orchiectomy. Because of rarity of epididymal leiomyosarcoma, the true biological behavior and the role of adjuvant chemotherapy and radiotherapy are not well defined. Long-term follow up is required for patients with a diagnosis of epididymal leiomyosarcoma.

Epididymal leiomyosarcoma

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