Spermatic cord leiomyosarcomas are uncommon malignant paratesticular masses.
Accounts for ~10% of spermatic cord sarcomas. The average of a patient at presentation is 58 years old (although has been seen as young as 15 years old).
Patients may have left inguinal swelling (typically painless).
As with other leiomyosarcomas, they arise from smooth muscle (in this instance smooth muscle in the spermatic cord). On gross pathology they appear as firm, smooth masses, which may demonstrate some necrosis and haemorrhage.
Although imaging findings can contribute to a differential diagnosis, biopsy is usually needed for diagnosis.
Primary modality for evaluation
- increased vascularity on colour Doppler
- more often in the scrotal part of the spermatic cord (lipoma more often at inguinal part)
- imaging features not defined
Treatment and prognosis
Treatment usually consists of transinguinal radical orchiectomy with adjuvant radiation therapy and chemotherapy.
- 1. Akbar SA, Sayyed TA, Jafri SZ et-al. Multimodality imaging of paratesticular neoplasms and their rare mimics. Radiographics. 2003;23 (6): 1461-76. doi:10.1148/rg.236025174 - Pubmed citation
- 2. Stein A, Kaplun A, Sova Y et-al. Leiomyosarcoma of the spermatic cord: report of two cases and review of the literature. World J Urol. 1996;14 (1): 59-61. Pubmed citation
- 3. Secil M, Kefi A, Gulbahar F et-al. Sonographic features of spermatic cord leiomyosarcoma. J Ultrasound Med. 2004;23 (7): 973-6. Pubmed citation
Ultrasound - testicular and scrotal
- ultrasound (introduction)
testicular and scrotal ultrasound
unilateral testicular lesion
- testicular torsion
- testicular rupture
- germ cell tumours of the testis
- sex cord / stromal tumours of the testis
- testicular cyst
- bilateral testicular lesion
- paratesticular lesions
- tubular ectasia of the rete testis
- cystadenoma of the rete testis
- testicular sarcoidosis
- testicular tuberculosis
- spermatic cord
- fibrous pseudotumour of the scrotum
- scrotal leiomyosarcoma
- testicular adrenal rest tumours (TARTs)
- tunica vaginalis testis mesothelioma
- splenogonadal fusion
- unilateral testicular lesion