Undifferentiated testicular pleomorphic sarcoma: A case report

BACKGROUND Genitourinary sarcomas include testicular sarcomas and are the most common subtype of sarcoma within the genitourinary system. Undifferentiated pleomorphic sarcoma is a subtype of soft tissue sarcomas that may affect the extremities and retroperitoneum. However, the presence within the testicle is rare. Here, we present a case of an undifferentiated testicular pleomorphic sarcoma, which will explore the presentation and treatment of a rare type of testicular cancer. CASE SUMMARY Here we present a 56-year-old male who comes to the urology clinic for left testicular swelling. The patient then underwent left radical orchiectomy via an inguinal approach for a left testicular mass seen on examination and on scrotal ultrasound. Pathology revealed undifferentiated pleomorphic sarcoma (Federation of the French Cancer Centres grade 3), 9.5 cm in size, and it was limited to the testicle. The surgical margins were negative. A follow-up positron emission tomography computed tomography scan was obtained, which showed no evidence of hypermetabolic lymph nodes or masses in the abdomen or pelvis. CONCLUSION Testicular sarcomas are a rare type of soft tissue sarcoma. The standard treatment of the testicular mass usually begins with radical inguinal orchiectomy. Patients with scrotal sarcomas are at high risk of local and distant recurrence, emphasizing the importance of surgical excision and wide margins. There is little studied regarding the integration of radiotherapy and chemotherapy for these cases as neoadjuvant or adjuvant therapies. This case highlights the presentation and treatment of a patient with a rare phenotype of testicular pleomorphic sarcoma treated by radical inguinal orchiectomy. In this study, our patient continued without nodal or distant disease in his initial positron emission tomography computed tomography scan after surgery.