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Malignant fibrous histiocytoma of the spermatic cord
D B Glazier1, T S Vates, K B Cummings
1Department of Surgery, Robert Wood Johnson University Hospital, New Brunswick, New Jersey 08903-0019, USA.
Purpose:
We analyzed 26 cases of malignant fibrous histiocytoma and report our conclusions regarding the diagnosis, pathology and treatment of this unusual tumor.
Materials And Methods:
We reviewed 25 previously reported cases of malignant fibrous histiocytoma of the spermatic cord and report 1 additional case. Further data on patient survival and tumor recurrence rates were obtained from some of the previous authors.
Results:
Of 26 patients 5 are long-term survivors (more than 5 years). Longest reported followup is 14 years. However, malignant fibrous histiocytoma has recurred as late as 6 years after surgery. To date 4 deaths have been reported, including 1 unrelated to the tumor and 3 from metastatic tumor. Disease recurred in 5 patients. In no case was there local lymph node involvement at surgery.
Conclusions:
Malignant fibrous histiocytoma presents earlier in the spermatic cord than at other sites and seems to have a more favorable prognosis. Ultrasound may aid in the diagnosis. Definitive treatment is radical orchiectomy but localized radiotherapy may decrease local recurrence rates. Satellite lesions at surgery indicate a poorer prognosis. Metastases may develop late in the lungs or mesentery, and so long-term followup is necessary.