腹股溝疝氣手術中意外在精索上發現黏液纖維肉瘤

徐易廷¹、張彰琦^2、3

¹臺北市立聯合醫院仁愛院區 外科部 泌尿科；²臺北市立聯合醫院忠孝院區 外科部 泌尿科³國立陽明交通大學 醫學院 泌尿學科

Accidental finding of myxofibrosarcoma of the spermatic cord during inguinal hernia surgery

Yi-Ting Hsu¹, Chan-Chi Chang^2、3

¹Division of Urology, Department of Surgery, Taipei City Hospital Renai Branch, Taipei, Taiwan;

²Division of Urology, Department of Surgery, Taipei City Hospital Zhongxiao Branch, Taipei, Taiwan;

³Department of Urology, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan

Background:

A myxofibrosarcoma(MFS) is a type of malignant tumor that typically appears as a slow-growing, painless lump on one of our limbs. MFS is a common soft tissue sarcoma in older adults. A 2.5 x 1.5cm soft tissue was dissected from the spermatic cord during our inguinal hernia surgery. Specimen pathology demonstrated incidental finding of myxofibrosarcoma(MFS).

Presentation of case:

The patient was an 84-year-old male with recently diagnosed prostate cancer., PSA: 392ng/ml, Gleason score: 4+5, and previous CT demonstrated lymph node up to 2 cm at right pelvic side well. At outpatient department, reducible right inguinal hernia was diagnosed and right inguinal hernioplasty was suggested. During operation, a 2.5cm mass was dissected from spermatic cord at inguinal area. The initial impression of the groin mass was inguinal lymph node metastasis of prostate cancer. The patient evolved with an uneventful postoperative period and he was discharged the next day. The specimen was a yellowish, multinodular soft tissue, measuring 2.5 x 1.5 x 1.1cm. The final pathology disclosed myxofibrosarcoma, grade 1.

Conclusions:

The case reported here was our experience of a low grade MFS of the spermatic cord found incidentally during inguinal hernia surgery. Spermatic cord tumors are relatively rare with 30-50% being malignant and most being soft-tissue sarcomas. Patient is at significant risks of local recurrence and metastasis. Development of effective adjuvant treatment is thus warranted.