REPRODUCTIVE > TESTIS & SCROTUM
Catalogue No: G5-n83-2532 Origin: UCT Anat Path museum Old Museum No: X:v:23 Year: 1971
The patient was a 28 year old man who presented with a short history of swelling of his left testis. Enlarged abdominal lymph nodes were detected, and an orchidectomy was therefore performed.
His testicular tumour was massive, measuring 19cm in greatest diameter; the outer surface was smooth (the slight wrinkling now evident being an artifact of fixation). The cut surface was creamy-yellow in colour, and gelatinous in consistency, the testis itself surrounded by tumour being the lobulated rectangular structure in the upper left portion of the specimen, just below the slit.
Microscopy revealed a rhabdomyosarcoma.
Sarcomas account for less than 2% of all urological tumours, but spermatic cord and paratesticular adnexal structure cases constitute 30% of all genitourinary sarcomas. Rhabdomyosarcomas are the most common paratesticular sarcoma in the 7-36 year old group, peaking at 2-5 years of age and with 60% occurring in the first two decades of life.
Patients typically present with a unilateral painless mass in the inguinal canal or scrotum, displacing (but not replacing) the testis on imaging.
The majority are of embryonal type histologically. Retroperitoneal lymph node dissection is recommended by many, since up to 50% are said to have metastases at presentation. The addition of chemotherapy has nowadays led to a quoted 80% survival after 3 years. (Whereas at the time of the original report it was stated that “death from widespread blood and lymphatic spread usually occurs within 2 years of diagnosis.)