J Korean Surg Soc.  2009 Nov;77(5):366-369. 10.4174/jkss.2009.77.5.366.

Myxoid Liposarcoma of the Spermatic Cord with Multiple Distant Metastasis

• Kim HH
• Hur YH
• Park CY
• Kim JC
• Kim SK

• KMID: 1750708
• DOI: http://doi.org/10.4174/jkss.2009.77.5.366

Abstract

Myxoid liposarcoma of the spermatic cord (MLSC) is a rare variant of spermatic sarcoma. Typically, it presents during the sixth decade of life as a painless scrotal or inguinal mass. Although local recurrences are not uncommon, prognosis following complete tumor removal is good because metastases are rare. Although myxoid liposarcoma is common elsewhere in the body, less than 20 cases have been described in the spermatic cord. Distant metastasis with MLSC (e.g., bone, liver, lung) is extremely rare, and no cases have been reported in the English literature. We report one case of MLSC with multiple bone, liver and peritoneal metastasis, incidentally found during inguinal hernia repair.

Keyword

Liposarcoma; Myxoid; Metastasis; Spermatic cord

MeSH Terms

Hernia, Inguinal
Liposarcoma
Liposarcoma, Myxoid
Liver
Neoplasm Metastasis
Prognosis
Recurrence
Sarcoma
Spermatic Cord

Figure

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  Fig. 1 Myxoid liposarcoma consisiting of lipoblast at various degrees of differentiation in myxoid stroma, prominent capillary vascular network and abundant mucosal substrate. (A, H&E, ×400) and positive immunohistochemical reactivity for S-100 (B, ×400).

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  Fig. 2 Whole body bone scan using 99m Tc-MDP demonstrated the hot uptake of right clavicle, right scapula, right 3rd and 4th anterior ribs, and 5th to 8th posterior ribs.

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  Fig. 3 The CT scan revealed a 1.5 cm hepatic metastasis in S4 (A, black-arrow) and peritoneal metastasis along right perirenal space and paracolic gutter (B, white-arrow).

Reference

1. Domsa I, Olinici CD, Crisan D. Spermatic cord mixed liposarcoma. Case report and review of the literature. Rom J Morphol Embryol. 2008. 49:105–109.

2. Enzinger FM, Weiss SW. Enzinger FM, Weiss SW, editors. Liposarcoma. Soft Tissue Tumors. 1995. 3rd ed. St. Louis: Mosby;431–466.

3. Fletcher CDM, Unni K, Mertens F. Adipocytic tumours. Pathology and Genetics of Tumors of Soft Tissue and Bone. 2002. Lyon: IARC Press;35–39.

4. Anjum MI, Eccersley J, Bhat A, Azzopard A, Khan O, Palmer JH. Liposarcoma of the spermatic cord: a report of two cases. Int Urol Nephrol. 1997. 29:227–232.

5. Montgomery E, Buras R. Incidental liposarcomas identified during hernia repair operations. J Surg Oncol. 1999. 71:50–53.

6. Vazquez-Lavista LG, Perez-Pruna C, Flores-Balcazar CH, Guzman-Valdivia G, Romero-Arredondo E, Ortiz-Lopez JB. Spermatic cord liposarcoma: a diagnostic challenge. Hernia. 2006. 10:195–197.

7. Murphey MD, Arcara LK, Fanburg-Smith J. From the archives of the AFIP: imaging of musculoskeletal liposarcoma with radiologic-pathologic correlation. Radiographics. 2005. 25:1371–1395.

8. Schwab JH, Boland P, Guo T, Brennan MF, Singer S, Healey JH, et al. Skeletal metastases in myxoid liposarcoma: an unusual pattern of distant spread. Ann Surg Oncol. 2007. 14:1507–1514.

9. Antonescu CR, Tschernyavsky SJ, Decuseara R, Leung DH, Woodruff JM, Brennan MF, et al. Prognostic impact of P53 status, TLS-CHOP fusion transcript structure, and histological grade in myxoid liposarcoma: a molecular and clinicopathologic study of 82 cases. Clin Cancer Res. 2001. 7:3977–3987.

10. Sheah K, Ouellette HA, Torriani M, Nielsen GP, Kattapuram S, Bredella MA. Metastatic myxoid liposarcomas: imaging and histopathologic findings. Skeletal Radiol. 2008. 37:251–258.