title: Paratesticular desmoplastic small round cell tumor: case report.
abstract: BACKGROUND
  The desmoplastic small round cell tumor has recently been separated from other small round cell tumors because of its characteristic pathological and clinical features. They are usually intra-abdominal tumors affecting young people and have classically been associated with a bad prognosis. However, in recent years there have reports on desmoplastic small round cell tumors affecting other body regions, including the paratesticular area.
  
  
  METHODS
  We report the case of a 23-year-old male, that consulted on a progressive enlargement of the right hemiscrotum in the last year and a half. He referred no previous urological symptoms and had no systemic symptomatology. Physical examination revealed a round elastic firm 2 to 3 cm mass distal to the tail of the epididymis, which was excised with a preoperative diagnosis of adenomatoid tumor. However, histological and immunohistochemical diagnosis confirmed a desmoplastic small round cell tumor. The extension study included a computed tomography scan and a plain chest radiograph, that showed no metastasis. The patient received chemoradiation therapy with methotrexate, dacarbacin, cyclophosphamide, actinomycin D and vincristin, but had to be changed to a vincristin, actinomycin D, cyclophosphamide and adriamicin scheme on severe toxicity. He completed five cycles of the chemotherapy with moderate toxicity. Today, 6 years after diagnosis the patient remains well and free of disease.
  
  
  CONCLUSIONS
  Recent reviews on desmoplastic small round cell tumor affecting the paratesticular area have shown a better prognosis for tumors of this origin compared to abdominal ones. We should include this lesion among the differential diagnosis of paratesticular tumors, mainly in children and adolescents.
authors.affiliation: Department of Urology, Hospital General of Móstoles, Madrid, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: García-González
authors.forename: Concepción
authors.initials: C
authors.lastname: Villanueva
authors.forename: M Jesús
authors.initials: MJ
authors.lastname: Fernández-Aceñero
authors.forename: Pedro
authors.initials: P
authors.lastname: Paniagua
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018288:Carcinoma, Small Cell / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D018572:Disease-Free Survival; D004822:Epididymis / Q000473:pathology*; D006801:Humans; D008297:Male; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy