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. 2023 Apr 3;85(5):1928-1931.
doi: 10.1097/MS9.0000000000000461. eCollection 2023 May.

Paratesticular rhabdomyosarcoma: a rare case report from Syria

Aziz Sabbagh  1 , Amr Hamza  2 , Mohamad Walid Sukkari  3 , Abdualh Fattal  4 , Anwar Chammout  5 , Kusay Ayoub  6 , Ibrahim Al-Hadid  1
Affiliations

Paratesticular rhabdomyosarcoma: a rare case report from Syria

Aziz Sabbagh et al. Ann Med Surg (Lond). .

Abstract

Paratesticular rhabdomyosarcoma (RMS) is a rare aggressive tumor manifesting in children and young adults. This tumor derives from mesenchymal elements of the Tunica vaginalis, epididymis, and spermatic cord. It is a very metastatic lesion that can spread by lymphatics to the iliac, para-aortic nodes, lung, and bone.

Case presentation: In this paper, the authors report a case of a 6-year-old child who presented to the clinic with a painless mass in the right side of the scrotum. The mass was misdiagnosed and had evolved rapidly over 2 weeks. The mass measured 16×32 mm on ultrasound, and therefore, an orchiectomy was performed. The histological examination of the excised tissue confirmed the diagnosis of paratesticular RMS.

Discussion: Paratesticular RMS mainly presented as a painless mass in the scrotum. It was a very metastatic lesion that required an immediate management. However, a lot of cases of paratesticular RMS misdiagnosed at first time, which worsens the overall prognosis.

Conclusion: Eventually, paratesticular RMS should be always taken into consideration when a scrotal mass is suspected. Due to its extremely serious metastatic potential, this condition requires early diagnosis and management. The treatment is currently well codified combining surgery, chemotherapy, and radiotherapy.

Keywords: paratesticular rhabdomyosarcoma; scrotum; testis; tumor.

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Conflict of interest statement

The authors report no conflicts of interests.

Figures

Figure 1
Figure 1
Transverse section of Doppler ultrasound shows the normal right testis (Rt sign + black circle) surrounded by a solid noncystic mass (white square), depressing on the right testicular tissue and measuring 16×32 mm. The blood flow to the mass is excessively elevated comparing with the normal right testis.
Figure 2
Figure 2
Intraoperative image shows the normal right testis (black arrows) surrounded by a large solid noncystic mass (white arrows).
Figure 3
Figure 3
(A) Microscopic study reveals malignant signs, nests of neoplastic round cells, nuclei that have a dark chromatin, presence of large cells with rounded eccentric eosinophilic cytoplasm, presence of mitosis activity. (B) Shows positivity for myoD1. (C) Shows positivity for myogenin. And (D) shows positivity for desmin.
See this image and copyright information in PMC

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