Primary osteosarcoma of the spermatic cord: case report and literature review

Primary osteosarcoma of the spermatic cord is a rare tumour with few mentions in the literature. A 59-year-old man presented with a large painless left inguinal and scrotal mass. The patient underwent excision of the mass, which arose from the spermatic cord. A left high dissection of the spermatic cord and radical orchiectomy due to associated atrophy of the left testicle were performed. Pathological findings were suggestive of spermatic cord osteosarcoma. The patient died eleven years later of metastatic lung disease. Spermatic cord osteosarcoma is an uncommon neoplasm and its preoperative diagnosis is very difficult. Any palpable suspicious mass of the cord should be investigated with ultrasonography before excision; CT scan and magnetic resonance imaging may be helpful in defining preoperative diagnosis and the extension of the mass into the neighbouring tissues. Surgical treatment of spermatic cord sarcomas in adults is via a radical orchiectomy with high dissection of the spermatic cord and en bloc excision of involved neighbouring tissues; overall 5- and 10-year survival rates are reported in the literature to be 75% and 55%, respectively.