title: Paratesticular Sarcoma: Typical Presentation, Imaging Features, and Clinical Challenges.
abstract: OBJECTIVE
  To describe the major imaging features, together with clinical data, of paratesticular sarcomas.
  
  
  METHODS
  A retrospective analysis was performed of available imaging and clinical data of 77 consecutive cases of paratesticular sarcoma referred to the soft tissue sarcoma center at the Royal Marsden hospital between January 2006 and January 2015.
  
  
  RESULTS
  Of the total cases, 87% had been referred postoperatively, 43% of which had been imaged preoperatively and 24% of which required re-resection due to incomplete initial excision. On imaging, abnormal fat was present in 73% of paratesticular liposarcomas, with solid or enhancing components indicating high-grade tumors. Leiomyosarcomas and rhabdomyosarcomas were all purely solid masses.
  
  
  CONCLUSIONS
  Paratesticular sarcomas are rare, and lack of awareness may compromise treatment and outcome. They may be mistaken for common clinical problems such as inguinal hernias and epididymal cysts. Surgery for these presumed diagnoses may result in inadequate clearance and an increased risk of recurrence. A low threshold for imaging atypical paratesticular masses is needed, as this may better inform management.
authors.affiliation: Department of Radiology, Royal Marsden NHS Foundation Trust, London, United Kingdom. Electronic address: derfelapdafydd@hotmail.com.
authors.forename: Derfel
authors.initials: D
authors.lastname: Ap Dafydd
authors.affiliation: Department of Radiology, Royal Marsden NHS Foundation Trust, London, United Kingdom.
authors.forename: Christina
authors.initials: C
authors.lastname: Messiou
authors.affiliation: Sarcoma Unit, Royal Marsden NHS Foundation Trust, London, United Kingdom.
authors.forename: Khin
authors.initials: K
authors.lastname: Thway
authors.affiliation: Department of Academic Surgery, Royal Marsden NHS Foundation Trust, London, United Kingdom.
authors.forename: Dirk C
authors.initials: DC
authors.lastname: Strauss
authors.affiliation: Department of Academic Surgery, Royal Marsden NHS Foundation Trust, London, United Kingdom; The Institute of Cancer Research, London, United Kingdom.
authors.forename: David L
authors.initials: DL
authors.lastname: Nicol
authors.affiliation: Department of Radiology, Royal Marsden NHS Foundation Trust, London, United Kingdom.
authors.forename: Eleanor
authors.initials: E
authors.lastname: Moskovic
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005834:Genital Neoplasms, Male / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D012189:Retrospective Studies; D012509:Sarcoma / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000628:therapy; D014057:Tomography, X-Ray Computed; D055815:Young Adult