Para-testicular Liposarcoma: An Update of the Literature | Chapter 01 | New Insights into Disease and Pathogen Research Vol. 4

Less than 200 cases of para-testicular liposarcoma (PTL) have been reported. PTL may present with painless or painful intra-scrotal or inguinoscrotal mass of long duration or recent onset but the most common presentation is a painless mass. Para-testicular liposarcomas does mimic various common intra-scrotal and inguinoscrotal masses, some of which include: inguinal hernia, lipoma, fibroma, fibrosarcoma, leiomyoma, leiomyosarcoma, rhabdomyosarcoma, various types of testicular tumours and other non-common intra-scrotal lesions. The symptoms tend to be non-specific. PTLs tend to be unilateral but bilateral cases have been reported. Radiology imaging would define the features of the lesion. Fine needle aspiration cytology could establish the diagnosis but the diagnosis tends to be established by pathology examination of the excised specimen of the tumour which would show spindled-tumoral cells with atypical features and mitotic activity and lipoblasts. Immunohistochemistry staining studies of the tumour would exhibit positive staining for MDM2, CDK4, S100 and STAT6. PTL is treated by trans-inguinal radical orchidectomy ensuring complete excision of the tumour with tumour-free excision margin plus adjuvant radiotherapy plus / minus adjuvant chemotherapy for localized disease. For metastatic and advanced lesions, radical trans-inguinal orchidectomy plus radiotherapy plus chemotherapy should be undertaken. New chemotherapy options need to be developed to effectively destroy para-testicular liposarcoma tumour cells. All excised innocuous looking intra-scrotal masses that should be submitted for histopathology examination in order not to misdiagnose PTL as benign lipoma. Generally the prognosis of localized PTL tends to be good following radical orchidectomy with complete excision of tumour.

Author(s) Details

Mr. Anthony Kodzo-Grey Venyo MB ChB FRCS(Ed) FRCSI FGCS Urol. LLM
Department of Urology, North Manchester General Hospital, Manchester, M8 5RB, United Kingdom.

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Carcinosarcoma of Ovary, It’s Histopathological, Management and Prognostic Analysis with Review of Literature | Chapter 15 | New Insights into Disease and Pathogen Research Vol. 2

Carcinosarcoma is a mixed malignant biphasic tumour representing a rare entity and comprises of both epithelial and mesenchymal components. Primary ovarian carcinosarcoma is a rare neoplasm with a number of cases reported in the literature in the hundreds. It accounts for less than 1% of all ovarian tumours. These tumours are usually diagnosed at older age and advanced stage. It has aggressive clinical behaviour and survival depends on stage at presentation. Radiological imagings cannot differentiate carcinosarcomas from other ovarian cancers. Diagnosis is based upon histological findings. Cytoreductive debulking surgery is a crucial part in the treatment of carcinosarcoma of ovary. The role of adjuvant chemotherapy regimen is still controversial. Combination chemotherapy with taxane and platinum based regimen or ifosfamide and platinum based regimen are considered as adjuvant treatment. Despite aggressive treatment modalities such as surgery and chemotherapy, the outcome is poor. Response to therapy and overall survival for carcinosarcoma are poor in comparison to that of epithelial ovarian malignancies. Due to rarity of the disease, such poor prognosis needs collaboration of studies with molecular analysis to obtain new therapeutic guidelines to improve survival of the patients.

Author(s) Details

Dr. Priyanka Priyadarshini
Department of Obstetrics and Gynaecology, Calcutta National Medical College and Hospital, Kolkata, West Bengal, 700014, India.

Dr. Tapan Kumar Sahoo
Department of Radiotherapy, Acharya Harihara Regional Cancer Centre, Cuttack, Odisha, 753007, India.

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