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Unusual Mass of the Spermatic Cord
0022-5347/03/1696-2298/0 THE JOURNAL OF UROLOGY® Copyright © 2003 by AMERICAN UROLOGICAL ASSOCIATION
Vol. 169, 2298, June 2003 Printed in U.S.A.
DOI: 10.1097/01.ju.0000065233.92653.b8
UNUSUAL MASS OF THE SPERMATIC CORD J. BRAECKMAN, P. VAN TICHELEN
AND
G. DERVAUX
From the Department of Urology, Academic Hospital, Vrije Universiteit Brussel, Brussels, Belgium KEY WORDS: genital neoplasms, male; soft tissue neoplasms; appendiceal neoplasms
A soft tissue mass of the spermatic cord is rare, and usually diagnosis is only made after pathological examination of the specimen, which is removed with the cord and corresponding testicle. We report a case of peritoneal inclusion cyst on an ectopic appendix herniating in the inguinal canal, which was easily resected from the spermatic cord.
the appendix, measuring about 8 cm. and terminating in a
CASE REPORT
A 75-year-old male was referred for a painless lump in the right groin. Physical examination revealed a soft mass in the inguinal region, separated from the right testicle in its normal scrotal position. There was no clinical sign of inflammation. Computerized tomography confirmed the presence of a 3 ⫻ 2 cm. abnormal mass adhering to the spermatic cord (fig. 1). The mass contained liquid and some small air bubbles, suggesting a diagnosis of abscess. Laboratory analysis of blood and urine samples was unremarkable. Surgical exploration was recommended, and the patient was informed that the right testicle might have to be removed together with the spermatic cord. At inguinal exploration the cord was easily separated from Accepted for publication January 24, 2003. FIG. 2. Surgical exploration reveals ectopic appendix terminating in peritoneal inclusion cyst.
cystic lesion (fig. 2). Appendectomy was performed and the patient returned home 1 day later with no further problems. Pathological evaluation demonstrated a normal appendix with a peritoneal inclusion cyst and some degree of periappendicitis. DISCUSSION
Tumors of the spermatic cord are rare.1 Benign (adenomatoid, lipoma) and malignant tumors (rhabdomyosarcoma, leiomyosarcoma, mesothelioma, fibrosarcoma, liposarcoma, myxosarcoma) can occur and, therefore, it is good policy to remove the testicle with high ligation of the cord.2 In this case the presence of what seemed and proved to be an appendix permitted preservation of the spermatic cord and testicle. REFERENCES
FIG. 1. Computerized tomography shows 3 ⫻ 2 cm. solid mass containing small air bubbles in right inguinal region.
2298
1. Arlen, M., Grabstald, H. and Whitmore, W. F., Jr.: Malignant tumors of the spermatic cord. Cancer, 23: 525, 1969 2. Samellas, W.: Malignant neoplasms of spermatic cord: liposarcoma. NY State J Med, 64: 1213, 1964
Vol. 169, 2298, June 2003 Printed in U.S.A.
DOI: 10.1097/01.ju.0000065233.92653.b8
UNUSUAL MASS OF THE SPERMATIC CORD J. BRAECKMAN, P. VAN TICHELEN
AND
G. DERVAUX
From the Department of Urology, Academic Hospital, Vrije Universiteit Brussel, Brussels, Belgium KEY WORDS: genital neoplasms, male; soft tissue neoplasms; appendiceal neoplasms
A soft tissue mass of the spermatic cord is rare, and usually diagnosis is only made after pathological examination of the specimen, which is removed with the cord and corresponding testicle. We report a case of peritoneal inclusion cyst on an ectopic appendix herniating in the inguinal canal, which was easily resected from the spermatic cord.
the appendix, measuring about 8 cm. and terminating in a
CASE REPORT
A 75-year-old male was referred for a painless lump in the right groin. Physical examination revealed a soft mass in the inguinal region, separated from the right testicle in its normal scrotal position. There was no clinical sign of inflammation. Computerized tomography confirmed the presence of a 3 ⫻ 2 cm. abnormal mass adhering to the spermatic cord (fig. 1). The mass contained liquid and some small air bubbles, suggesting a diagnosis of abscess. Laboratory analysis of blood and urine samples was unremarkable. Surgical exploration was recommended, and the patient was informed that the right testicle might have to be removed together with the spermatic cord. At inguinal exploration the cord was easily separated from Accepted for publication January 24, 2003. FIG. 2. Surgical exploration reveals ectopic appendix terminating in peritoneal inclusion cyst.
cystic lesion (fig. 2). Appendectomy was performed and the patient returned home 1 day later with no further problems. Pathological evaluation demonstrated a normal appendix with a peritoneal inclusion cyst and some degree of periappendicitis. DISCUSSION
Tumors of the spermatic cord are rare.1 Benign (adenomatoid, lipoma) and malignant tumors (rhabdomyosarcoma, leiomyosarcoma, mesothelioma, fibrosarcoma, liposarcoma, myxosarcoma) can occur and, therefore, it is good policy to remove the testicle with high ligation of the cord.2 In this case the presence of what seemed and proved to be an appendix permitted preservation of the spermatic cord and testicle. REFERENCES
FIG. 1. Computerized tomography shows 3 ⫻ 2 cm. solid mass containing small air bubbles in right inguinal region.
2298
1. Arlen, M., Grabstald, H. and Whitmore, W. F., Jr.: Malignant tumors of the spermatic cord. Cancer, 23: 525, 1969 2. Samellas, W.: Malignant neoplasms of spermatic cord: liposarcoma. NY State J Med, 64: 1213, 1964