睪丸旁去分化脂肪肉瘤 : 罕見病例報告

陳建凱、石宏仁

彰化基督教醫院 外科部 泌尿科

Paratesticular dedifferentiated liposarcoma : a rare case report

Jian-Kai Chen、Hung-Jen Shih

Divisions of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan

Introduction:

    Paratesticular liposarcoma is an uncommon neoplasm of the genitourinary tract, with the dedifferentiated variant accounting for only 10% of liposarcoma cases. We report a case of paratesticular dedifferentiated liposarcoma treated with surgical resection.

Case report:

    A 73-year-old male with no underlying medical conditions presented to our outpatient department in July 2023, reporting a right scrotal mass that had been troubling him for an extended period. A review of his previous medical records indicated that during a visit to another medical facility in January 2022, his alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) levels were within the normal range. However, the mass had grown in recent months.

   To further investigate, an MRI was conducted, which revealed a 2x1.8 cm neoplasm in the spermatic cord, suspected to be an epididymal or spermatic cord tumor. Given these findings, a right radical orchiectomy was performed to address the potential neoplastic growth. During the operation, a hard tumor involving the right epididymis with spermatic cord invasion was observed. The pathology report, based on morphology and immunophenotype, confirmed dedifferentiated liposarcoma with invasion of the epididymis and spermatic cord. The patient was subsequently lost to follow-up after the operation.

Conclusion:

Paratesticular liposarcoma requires extensive surgical intervention, typically involving radical orchiectomy, for curative treatment. The dedifferentiated subtype is rare and has a propensity for local recurrence. While patients face an elevated risk of local recurrence post-surgery, the incidence of distant metastasis is lower. Therefore, long-term follow-up is recommended.