Metastatic Paratesticular Leiomyosarcoma in a Young Male: A Case Report

Abstract

Para-testicular leiomyosarcoma is rare, especially in young men. This is a case of a 16-year-old male presenting with a painless progressive right hemi scrotal swelling of 1 year duration and right sided abdominal mass of 2 months duration. Radiological investigations revealed a right intra-scrotal tumor sparing the testis with abdominal metastasis. The patient had right radical orchidectomy with high ligation of spermatic cord and excision of attached scrotal skin. Histopathology revealed para-testicular leiomyosarcoma likely arising from the scrotal wall. He subsequently had eight courses of adjuvant combination chemotherapy and also radiotherapy to the right hemiscrotum. He however presented with local recurrence twelve months later and had right hemiscrotectomy and pathology revealed leiomyosarcoma. The role of chemotherapy in treatment of metastatic para-testicular leiomyosarcoma has not been well established. However, this case has shown good response to adjuvant systemic combination chemotherapy.