Primary pure angiosarcoma of the testis: a vanishingly rare malignancy. Case report and literature review

Springer Science and Business Media LLC - Tập 20 - Trang 1-8 - 2020
J. Walravens-Evans1, M. Yao2, S. Grannò3, D. Arul4, S. Chitale5
1Kingston Hospital NHS Foundation Trust, Surrey, UK
2Department of Urology, Kent and Canterbury Hospital, Canterbury, UK
3UCL School of Life and Medical Sciences, London, UK
4Department of Pathology, Whittington Hospital, London, UK
5Department of Urology, Whittington Hospital, London, UK

Tóm tắt

Primary pure angiosarcoma of the testis is an exceptionally rare testicular malignancy, which is poorly understood. We present the fifth and youngest case in the current medical literature. Additionally, all cases of angiosarcoma of the testicle, both occurring with associated germ cell tumour and without, were compared in an extended tabular format. A 56-year old man presented with unilateral scrotal pain, swelling and erythema. Ultrasonography revealed two testicular lesions with a high suspicion of malignancy but serum tumour markers were negative. A radical orchidectomy was performed with clear surgical margins. Diagnosis of primary pure angiosarcoma of the testis was confirmed on subsequent histopathology. Primary pure angiosarcoma is a rare testicular neoplasm. We present the fifth case in the literature. Clinical and radiological features are non-specific. The diagnosis is purely histological, with the pathologist choosing immunohistochemistry based on abnormal morphology. Local invasiveness is variable but metastatic sites are typical for extra-gonadal angiosarcomas. Primary pure testicular angiosarcoma diagnosis confers a relatively better prognosis compared to angiosarcoma arising in the context of a testicular germ cell tumour. While extra-gonadal angiosarcomas are associated with high rates of local recurrence following resection, in all cases of testicular angiosarcoma there were no local recurrences following radical orchidectomy. Surgical resection remains the most effective treatment for both subtypes of testicular angiosarcoma.

Tài liệu tham khảo

Fury MG, et al. A 14-year retrospective review of angiosarcoma: clinical characteristics, prognostic factors, and treatment outcomes with surgery and chemotherapy. Cancer J. 2005;11(3):241–7.

Mark RJ, et al. Angiosarcoma. A report of 67 patients and a review of the literature. Cancer. 1996;77(11):2400–6.

Meis-Kindblom JM, Kindblom LG. Angiosarcoma of soft tissue: a study of 80 cases. Am J Surg Pathol. 1998;22(6):683–97.

Gaballah AH, et al. Angiosarcoma: clinical and imaging features from head to toe. Br J Radiol. 2017;90(1075):20170039.

Motzer RJ, et al. Teratoma with malignant transformation: diverse malignant histologies arising in men with germ cell tumors. J Urol. 1998;159(1):133–8.

Ulbright TM. Testis risk and prognostic factors. The pathologist’s perspective. Urol Clin North Am. 1999;26(3):611–26.

Idrees MT, et al. Clonal evidence for the progression of a testicular germ cell tumor to angiosarcoma. Hum Pathol. 2010;41(1):139–44.

Bahrami A, Ro JY, Ayala AG. An overview of testicular germ cell tumors. Arch Pathol Lab Med. 2007;131(8):1267–80.

Winter C, Albers P. Testicular germ cell tumors: pathogenesis, diagnosis and treatment. Nat Rev Endocrinol. 2011;7(1):43–53.

Hayes-Lattin B, Nichols CR. Testicular cancer: a prototypic tumor of young adults. Semin Oncol. 2009;36(5):432–8.

Ruf CG, et al. Changes in epidemiologic features of testicular germ cell cancer: age at diagnosis and relative frequency of seminoma are constantly and significantly increasing. Urol Oncol. 2014;32(1):33.e1–6.

Ahmed T, Bosl GJ, Hajdu SI. Teratoma with malignant transformation in germ cell tumors in men. Cancer. 1985;56(4):860–3.

Ulbright TM, Clark SA, Einhorn LH. Angiosarcoma associated with germ cell tumors. Hum Pathol. 1985;16(3):268–72.

Fizazi K, et al. Germ cell tumors in patients infected by the human immunodeficiency virus. Cancer. 2001;92(6):1460–7.

Malagon HD, et al. Germ cell tumors with sarcomatous components: a clinicopathologic and immunohistochemical study of 46 cases. Am J Surg Pathol. 2007;31(9):1356–62.

Masera A, Ovcak Z, Mikuz G. Angiosarcoma of the testis. Virchows Arch. 1999;434(4):351–3.

Armah HB, Rao UN, Parwani AV. Primary angiosarcoma of the testis: report of a rare entity and review of the literature. Diagn Pathol. 2007;2:23.

Jain S, Cantley R, Philip J. Primary pure angiosarcoma of the testis: a case report. Transl Univ Toledo J Med Sci. 2014;1:C1-3.

Piotrowski JT, et al. Primary angiosarcoma of the testis with retroperitoneal metastasis. Urol Case Rep. 2018;21:116–8.

Hughes DF, Allen DC, O’Neill JJ. Angiosarcoma arising in a testicular teratoma. Histopathology. 1991;18(1):81–3.

Lee KC, et al. Angiosarcoma following treatment of testicular seminoma: case report and literature review. J Urol. 1995;153(3 Pt 2):1055–6.

Steele GS, et al. Angiosarcoma arising in a testicular teratoma. J Urol. 2000;163(6):1872–3.

Sahoo S, et al. Angiosarcoma masquerading as embryonal carcinoma in the metastasis from a mature testicular teratoma. Arch Pathol Lab Med. 2003;127(3):360–3.

Behre HM. Andrology: male reproductive health and dysfunction. Berlin: Springer; 1997.

Berney DM, et al. Malignant germ cell tumours in the elderly: a histopathological review of 50 cases in men aged 60 years or over. Mod Pathol. 2008;21(1):54–9.

Heidenreich A, et al. Organ sparing surgery for malignant germ cell tumor of the testis. J Urol. 2001;166(6):2161–5.

Dearnaley DP, et al. Combination chemotherapy with bleomycin, etoposide and cisplatin (BEP) for metastatic testicular teratoma: long-term follow-up. Eur J Cancer. 1991;27(6):684–91.

Hamilton C, et al. Radiotherapy for stage I seminoma testis: results of treatment and complications. Radiother Oncol. 1986;6(2):115–20.

Classen J, et al. Radiotherapy for stages IIA/B testicular seminoma: final report of a prospective multicenter clinical trial. J Clin Oncol. 2003;21(6):1101–6.

Patel HD, et al. Radiotherapy for stage I and II testicular seminomas: Secondary malignancies and survival. Urol Oncol. 2017;35(10):606.e1-606.e7.

Thông tin
Thông tin xuất bản

Springer Science and Business Media LLC

Tập 20

1-8

Thông tin tác giả