MALIGNANT FIBROUS HISTIOCYTOMA OF THE SPERMATIC CORD

Purpose: We analyzed 26 cases of malignant fibrous histiocytoma and re port our conclusions regarding the diagnosis, pathology and treatment of this unusual tumor. Materials and Methods: We reviewed 25 previousl y reported cases of malignant fibrous histiocytoma of the spermatic co rd and report 1 additional case. Further data on patient survival and tumor. recurrence rates were obtained from some of the previous author s. Results: Of 26 patients 5 are long-term survivors (more than 5 year s). Longest reported followup is 14 years. However, malignant fibrous histiocytoma has recurred as late as 6 years after surgery. To date 4 deaths have been reported, including 1 unrelated to the tumor and 3 fr om metastatic tumor. Disease recurred in 5 patients. In no case was th ere local lymph node involvement at surgery. Conclusions: Malignant fi brous histiocytoma presents earlier in the spermatic cord than at othe r sites: and seems to have a more favorable prognosis. Ultrasound may aid in the diagnosis. Definitive treatment is radical orchiectomy but localized radiotherapy may decrease local recurrence rates. Satellite lesions at surgery indicate a poorer prognosis. Metastases may develop late in the lungs or mesentery, and so long-term followup is necessar y.