Rhabdomyosarcoma of spermatic cord in a 65-year-old man presenting as a groin swelling

Abstract

A 65-year-old man presented with a swelling in the right groin of 6 months duration. The swelling was associated with dull aching pain and the patient reported of increase in size of the swelling during lifting of heavy weights. The swelling was 6×5 cm, hard in consistency, mobile and there was no impulse of cough. Ultrasonography showed a solid mass measuring 5.3×1.5×5.2 cm arising from the spermatic cord. High-inguinal orchiectomy was performed. Histopathology revealed rhabdomyosarcoma (RMS) of the spermatic cord. Patient was advised adjuvant chemotherapy but he refused. Spermatic cord RMS is a rare tumour derived from the undifferentiated mesoderm. It is most often observed in children and adolescents. It rarely appears after the second decade of life. It usually manifests as a painless, firm to hard mass in the inguinal canal or scrotum. Radical high-inguinal orchiectomy is the treatment of choice.

Figure 1

Swelling in the right inguinal region measuring 6×5 cm.

Figure 2

Rhabdomyosarcoma arising from the spermatic cord on inguinal exploration.

Figure 3

Gross specimen showing globular, grey white, capsulated soft tissue mass (measuring 5×2x5 cm) with bosselated external surface. On cut section—grey white, lobulated with foci of haemorrhagic areas.