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Aktuelle Urol 2024; 55(02): 148-153
DOI: 10.1055/a-1345-6808
Original article

The fate of paratesticular masses: 13 years’ experience in a tertiary referral centre

Das Schicksal paratestikulärer Massen: 13 Jahre Erfahrung eines tertiären Überweisungszentrums
Huseyin Cihan Demirel
1   Şişli Hamidiye Etfal Training and Research Hospital, Urology, Şişli, Turkey
,
Emre Tokuç 
2   Istanbul Sultanbeyli State Hospital, Urology, Istanbul, Turkey
,
Ozlem Ton Eryilmaz
3   Şişli Hamidiye Etfal Training and Research Hospital, Pathology, Şişli, Turkey
,
Emre Aykanli
1   Şişli Hamidiye Etfal Training and Research Hospital, Urology, Şişli, Turkey
,
Abdullah Hizir Yavuzsan
1   Şişli Hamidiye Etfal Training and Research Hospital, Urology, Şişli, Turkey
,
Ayse Aysim Ozagari
3   Şişli Hamidiye Etfal Training and Research Hospital, Pathology, Şişli, Turkey
,
Sinan Levent Kirecci
1   Şişli Hamidiye Etfal Training and Research Hospital, Urology, Şişli, Turkey
,
Kaya Horasanli
1   Şişli Hamidiye Etfal Training and Research Hospital, Urology, Şişli, Turkey
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Abstract

Objective Paratesticular neoplasms exhibit different behaviours, depending on the embryological tissue of origin. Treatment modalities can depend on the differential diagnosis. The aim of this study is to present the clinical, morphological and histopathological features of patients with paratesticular masses and their follow-ups and is intended to increase awareness of the issues.

Methodology We included 31 excisions of paratesticular masses, after radiological diagnosis as paratesticular mass in our hospital between 2007–2020. Information on treatment modalities, tumour recurrence, metastasis, and survival rates were obtained from hospital archives. All patients were evaluated by taking patients’ history, physical examination, scrotal ultrasound, chest radiography, and serum tumour markers. Treatment modality was selected according to intraoperative findings. Haematoxylin-eosin sections were examined, and immunohistochemical analyses were performed for smooth muscle actin, desmin, Ki67, CD34, S100, and myogenin. Ten high-power fields were counted to document Ki67 and p53 nuclear positivity rates.

Results A total of 31 operations were performed with recurrence in three patients. Histomorphological and immunohistochemical examination revealed eleven malignant masses; eight rhabdomyosarcomas, a leiomyosarcoma, a liposarcoma and a large B cell lymphoma. Other excised masses were benign and infective lesions.

Conclusion Paratesticular masses are heterogeneous tumours that follow different clinical courses. Clinicians must be aware of this histological diversity in order to plan a treatment pathway. This study is one of the largest published series, with a long follow-up period. It shows that the most critical features in determining prognosis are histopathological subtype and tumour grade.

Zusammenfassung

Ziel Paratestikuläre Neoplasien zeigen aufgrund der Vielfalt der embryologischen Gewebe, aus denen sie stammen, unterschiedliche Verhaltensmuster. Die Behandlungsmodalitäten können je nach Differentialdiagnose unterschiedlich sein. Ziel dieser Studie ist es, die klinischen, morphologischen und histopathologischen Merkmale von Patienten mit paratestikulären Massen und ihre Follow-ups zur Sensibilisierung darzustellen.

Methodik Einunddreißig paratestikuläre Massenentfernungen, die an achtundzwanzig Patienten durchgeführt wurden, bei denen zwischen 2007 und 2020 in unserem Krankenhaus radiologisch eine paratestikuläre Masse diagnostiziert wurde, wurden eingeschlossen. Informationen zu Behandlungsmodalitäten, Tumorrezidiven, Metastasen und Überlebensraten wurden aus Krankenhausarchiven erhalten. Alle Patienten wurden anhand der Anamnese, der körperlichen Untersuchung, des Skrotalultraschalls, der Röntgenaufnahme des Brustkorbs und der Serumtumor-Marker bewertet. Die Behandlungsmethode wurde nach intraoperativen Befunden ausgewählt. Hämatoxylin-Eosin-Schnitte wurden untersucht und immunhistochemische Analysen wurden für Aktin, Desmin, Ki67, CD34, S100 und Myogenin der glatten Muskulatur durchgeführt. Zehn Hochleistungsfelder wurden gezählt, um die positiven Positivitätsraten von Ki67 und p53 zu dokumentieren.

Ergebnisse Bei 31 Patienten wurden insgesamt einunddreißig Operationen mit Rezidiv durchgeführt. Die histomorphologische und immunhistochemische Untersuchung ergab elf bösartige Massen; acht Rhabdomyosarkome, ein Leiomyosarkom, ein Liposarkom und ein großes B-Zell-Lymphom. Andere ausgeschnittene Massen waren gutartige und infektiöse Läsionen.

Schlussfolgerung Paratestikuläre Massen sind heterogene Tumoren, die unterschiedlichen klinischen Verläufen folgen. Ärzte müssen sich dieser histologischen Vielfalt bewusst sein, um einen Behandlungsweg planen zu können. Diese Studie ist eine der größten Reihen in der Literatur mit langer Nachbeobachtungszeit, die auch zeigt, dass die wichtigsten Merkmale bei der Bestimmung der Prognose der histopathologische Subtyp und der Tumorgrad sind.

Keywords

Orchiectomy - Paratestis - Scrotum - Sarcoma - Tumor

Schlüsselwörter

Orchiektomie - Paratestis - Hodensack - Sarkom - Tumor


Publication History

Article published online:
14 April 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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