Organ-sparing Surgery in Treating Patients with Liposarcoma of the Spermatic Cord: Institutional Experience and Pooled Analysis

  • Cao, Ming-Xin (Department of Urology, the First Affiliated Hospital of Sun Yat-sen University) ;
  • Chen, Jie (Department of Urology, the First Affiliated Hospital of Jinan University) ;
  • Zhang, Jun-Long (Department of Urology, the First Affiliated Hospital of Sun Yat-sen University) ;
  • Wei, Xin (Department of Pathology, the First Affiliated Hospital of Sun Yat-sen University) ;
  • Liang, Yue-You (Department of Urology, the First Affiliated Hospital of Sun Yat-sen University)
  • Published : 2015.04.29


Background: Liposarcoma of the spermatic cord is rare and frequently misdiagnosed. The standard therapeutic approach has been radical inguinal orchiectomy with wide local resection of surrounding soft tissues. The current trend of organ preservation in the treatment of several cancers has started to evolve. Herein we present our testis-sparing surgery experience in the treatment of spermatic cord liposarcoma and a pooled analysis on this topic. Materials and Methods: Clinical information from patient receiving organ-sparing surgery was described. Clinical studies evaluating this issue were identified by using a predefined search strategy, e.g., Pubmed database with no restriction on date of published papers. The literature search used the following terms: epidemiology, surgery, chemotherapy, radiotherapy, testis sparing surgery, spermatic cord sarcomas/liposarcomas. Results: Patient received a complete excision of the lesion, preserving the spermatic cord and the testis. The final pathological report showed a well differentiated liposarcoma with negative surgical margins and no signs of local invasion. After 2-year of follow-up, there was no evidence of local recurrence. Since the first case reported in 1952, a total of about 200 well-documented spermatic cord liposarcoma cases have been published in English literature. Among these patients, only three instances were reported to have received an organ-sparing surgery in the treatment of spermatic cord liposarcoma. Conclusions: Radical inguinal orchiectomy and resection of the tumor with a negative microscopic margin is the recommended treatment for liposarcoma of the spermatic cord. But for small, especially well-differentiated, lesions, testis-sparing surgery might be a good option if an adequate negative surgical margin is assured.


Liposarcoma;orchiectomy;organ;sparing surgery;spermatic cord


  1. Akbar SA, Sayyed TA, Jafri SZ, et al (2003). Multimodality imaging of paratesticular neoplasms and their rare mimics. Radiographics, 23, 1461-76.
  2. Alyousef H, Osman EM, Gomha MA (2013). Paratesticular liposarcoma: a case report and review of the literature. Case Rep Urol, 2013, 806289.
  3. Ballo MT, Zagars GK, Pisters PW, et al (2001). Spermatic cord sarcoma: outcome, patterns of failure and management. J Urol, 166, 1306-10.
  4. Cardenosa G, Papanicolaou N, Fung CY, et al (1990). Spermatic cord sarcomas: sonographic and CT features. Urol Radiol, 12, 163-7.
  5. Chintamani, Tandon M, Khandelwal R, et al (2010). Liposarcoma of the spermatic cord: a diagnostic dilemma. JRSM Short Rep, 1, 49.
  6. Coleman J, Brennan MF, Alektiar K, et al (2003). Adult spermatic cord sarcomas: management and results. Ann Surg Oncol, 10, 669-75.
  7. Cui L, Liu XX, Jiang Y, et al (2014)Phase II study on dose escalating schedule of paclitaxel concurrent with radiotherapy in treating patients with locally advanced non-small cell lung cancer. Asian Pac J Cancer Prev, 15, 1699-702.
  8. Dotan ZA, Tal R, Golijanin D, et al (2006). Adult genitourinary sarcoma: the 25-year Memorial Sloan-Kettering experience. J Urol, 176, 2033-9.
  9. Fitzgerald S, Maclennan GT (2009). Paratesticular liposarcoma. J Urol, 181, 331-2.
  10. Folpe AL, Weiss SW (2000). Paratesticular soft tissue neoplasms. Semin Diagn Pathol, 17, 307-18.
  11. Frates MC, Benson CB, DiSalvo DN, et al (1997). Solid extratesticular masses evaluated with sonography:pathologic correlation. Radiology, 204, 43-6.
  12. Geer RJ, Woodruff J, Casper ES, et al (1992). Management of small soft-tissue sarcoma of the extremity in adults. Arch Surg, 127, 1285-9.
  13. Giannarini G, Dieckmann KP, Albers P, et al (2010) Organsparing surgery for adult testicular tumours: a systematic review of the literature. Eur Urol, 57, 780-90.
  14. Guttilla A, Crestani A, Zattoni F, et al (2013) Spermatic cord sarcoma: our experience and review of the literature. Urol Int, 90, 101-5.
  15. Hsu YF, Chou YY, Cheng YH (2012). Spermatic cord myxoid liposarcoma presenting as an incarcerated inguinal hernia:report of a case and review of literatures. Hernia, 16, 719-22.
  16. Huang XE, Tian GY, Cao J, et al (2014). Pemetrexed as a component of first-, second- and third- line chemotherapy in treating patients with metastatic lung adenocarcinoma. Asian Pac J Cancer Prev, 14, 6663-7.
  17. Ji ZQ, Huang XE, Wu XY, et al (2014). Safety of Brucea javanica and cantharidin combined with chemotherapy for treatment of NSCLC patients. Asian Pac J Cancer Prev, 15, 8603-5.
  18. Khandekar MJ, Raut CP, Hornick JL, et al (2013). Paratesticular liposarcoma: unusual patterns of recurrence and importance of margins. Ann Surg Oncol, 20, 2148-55.
  19. Kooby DA, Antonescu CR, Brennan MF, et al (2004). Atypical lipomatous tumor/well-differentiated liposarcoma of the extremity and trunk wall: importance of histological subtype with treatment recommendations. Ann Surg Oncol, 11, 78-84.
  20. Lu J, Qin Q, Zhan LL, et al (2014). Computed tomography manifestations of histologic subtypes of retroperitoneal liposarcoma. Asian Pac J Cancer Prev, 15, 6041-6.
  21. Manzia TM, Gravante G, Toti L, et al (2010) Management of spermatic cord liposarcoma in renal transplant recipients:case report. Transplant Proc, 42, 1355-7.
  22. Montgomery E, Fisher C (2003). Paratesticular liposarcoma: a clinicopathologic study. Am J Surg Pathol, 27, 40-7.
  23. Peralta JP, Godinho R, Rabaca C, et al (2013). Spermatic cord liposarcoma: organ-sparing surgery. BMJ Case Rep, 2013.
  24. Peterson JJ, Kransdorf MJ, Bancroft LW, et al (2003). Malignant fatty tumors: classification, clinical course, imaging appearance and treatment. Skeletal Radiol, 32, 493-503.
  25. Radaelli S, Desai A, Hodson J, et al (2014). Prognostic factors and outcome of spermatic cord sarcoma. Ann Surg Oncol, 21, 3557-63.
  26. Rodriguez D, Barrisford GW, Sanchez A, et al (2014). Primary spermatic cord tumors: disease characteristics, prognostic factors, and treatment outcomes. Urol Oncol, 32, 19-52.
  27. Rodriguez D, Olumi AF (2012) Management of spermatic cord tumors: a rare urologic malignancy. Ther Adv Urol, 4, 325-34.
  28. Schwartz SL, Swierzewski SR, Sondak VK, et al (1995). Liposarcoma of the spermatic cord: report of 6 cases and review of the literature. J Urol, 153, 154-7.
  29. Secil M, Kefi A, Gulbahar F, et al (2004). Sonographic features of spermatic cord leiomyosarcoma. J Ultrasound Med, 23, 973-6, 977-8.
  30. Woodward PJ, Schwab CM, Sesterhenn IA (2003). From the archives of the AFIP: extratesticular scrotal masses:radiologic-pathologic correlation. Radiographics, 23, 215-40.