Spermatic cord liposarcoma

Spermatic cord liposarcomas are the most common malignant tumor of the spermatic cord. Most present as painless, slow-growing masses and can be mistaken for inguinal hernias. They are usually well-differentiated and spread by local extension. 

Epidemiology

In a large population-based registry, the annual incidence of spermatic cord tumor (SCT) is 0.3 cases/million ³.

Clinical presentation

Most present as painless, slow-growing masses. They can be mistaken for an inguinal hernia, hydrocele, or other paratesticular tumors. 

Pathology

Most are low-grade and well-differentiated and spread by local extension. High-grade tumors can spread via hematogenous or lymphatic routes ³. 

In a large population-based registry, 362 patients with SCT were identified, with histological subtypes of liposarcoma (46%), leiomyosarcoma (20%), histiocytoma (13%), and rhabdomyosarcoma (9%) ³. 

Radiographic features

CT and MRI provide greater characterization and staging information than ultrasound. They appear as a fat-containing tumor with variable amounts of soft tissue, nodularity, and septations. 

Treatment and prognosis

Standard surgical treatment includes high orchiectomy and resection of the tumor and spermatic cord. Lymph node dissection is occasionally performed. Chemotherapy and radiation therapy depend on the tumor grade, stage, and risk of recurrence¹. 

Differential diagnosis

Lipoma is the most common benign tumor of the spermatic cord, and much more common than liposarcoma (45% of paratesticular masses)³. Other malignant tumors of the spermatic cord include leiomyosarcoma, histiocytoma, and rhabdomyosarcoma. 

See also

• paratesticular lesions