Role of radiotherapy in the treatment of fibrosarcoma of the spermatic cord: a case report and review of the literature.
BACKGROUND
Spermatic cord sarcomas are rare. The therapeutic approach is based only on case reports and small series. The standard treatment is radical orchiectomy with wide local resection, while the role of adjuvant therapies is not clear. We present a case of fibrosarcoma of the spermatic cord treated with surgery and adjuvant radiotherapy. A review of the literature about the role of adjuvant treatments is also discussed.


METHODS
A 59-year-old man presented a right testicular mass of about 4 × 3 cm in size. Biopsy showed a high-grade polymorphous sarcoma, consistent with a diagnosis of poorly differentiated fibromyosarcoma. He underwent a right radical inguinal orchiectomy and adjuvant radiotherapy (total dose: 5940 cGy). During treatment the patient developed a G3 skin toxicity (RTOG score) in the inguinal fold. After a follow-up of 57 months, he is alive and without evidence of local or distant recurrence. No late toxicity was noted.


CONCLUSIONS
The optimal adjuvant management of spermatic cord sarcoma is still uncertain. Looking at the literature, it seems that adjuvant radiotherapy can improve locoregional control and disease-free survival without additional late toxicity.
Radiation Oncology Service, Bioimages and Radiological Science Department, Catholic University, Rome, Italy.
Mario
M
Balducci
Alessia
A
Di Rito
Giovanna
G
Mantini
Stefania
S
Manfrida
Silvia
S
Chiesa
Vincenzo
V
Frascino
Giuseppe Roberto
GR
D'Agostino
Vincenzo
V
Valentini
Berardino
B
De Bari
D018572:Disease-Free Survival; D005354:Fibrosarcoma / Q000532:radiotherapy* / Q000601:surgery*; D005834:Genital Neoplasms, Male / Q000532:radiotherapy* / Q000601:surgery*; D006119:Groin; D006801:Humans; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012867:Skin / Q000528:radiation effects; D013085:Spermatic Cord / Q000473:pathology / Q000528:radiation effects; D016896:Treatment Outcome