Strangulated inguinal hernia accompanied by paratesticular leiomyosarcoma

Sarcomas that arise from the spermatic cord constitute 2.1% of soft tissue sarcomas and are observed at a rate of 1% to 2% in the genitourinary system. A 74-year-old patient presented at the emergency department with complaints of groin pain and swelling persisting for 3 days. On physical examination, a firm mass that was approximately 5x5 cm in size and could not be reduced was observed at the right inguinal area as well as a right inguinal hernia. Computed tomography revealed a large hernia sac in the right inguinal area and a mass that was 77x55 mm in size within the hernial sac. A radical orchiectomy and hernia repair were performed. A diagnosis of leiomyosarcoma was made based on the pathological evaluation of the mass. At the 7-month postoperative follow-up, no local relapse or distant metastasis was found. To conclude, although paratesticular leiomyosarcoma is rare, it should be kept in mind as one of the possible diagnoses for older patients presenting with an inguinal mass.

Strangüle inguinal herniye eþlik eden paratestiküler leiomiyosarkom

Spermatik kord kaynaklý sarkomlar yumuþak doku sarkomlarýnýn %2.1 ve genitoüriner sistemde ise %1–2 oranlarýnda görülen nadir malignitedir. Yetmiþ dört yaþýnda erkek hasta son üç gündür süren kasýk aðrýsý ve þiþlik þikâyeti ile acil polikliniðimize baþvurdu. Fizik muayenede sað inguinal bölgede yaklaþýk 5x5 cm boyutlarýnda sert redükte edilemeyen kitle ve sað inguinal herni tespit edildi. Bilgisayarlý tomografide sað inguinal bölgede büyük bir herni kesesi ve içerisinde 77x55 mm ölçülerinde kitle saptanan hastaya radikal orþiektomi ve herni onarýmý yapýldý. Kitlenin patolojik deðerlendirmesinde paratestiküler leiomyosarkom tanýsý konuldu. Ameliyat sonrasý yedinci ayda lokal nüks veya uzak metastaz izlenmedi. Sonuç olarak paratestiküler leiomyosarkomlar nadir görülmelerine raðmen özellikle inguinal kitle ile baþvuran ileri yaþtaki hasta grubunda akýlda tutulmasý gereken bir durumdur.