PRIMARY INTRATESTICULAR SARCOMA - IMMUNOHISTOCHEMICAL ULTRASTRUCTURALAND DNA FLOW CYTOMETRIC STUDY OF 3 CASES WITH A REVIEW OF THE LITERATURE

BACKGROUND, Fourteen cases of testicular sarcoma have been reported in the contemporary era. These included 7 cases of rhabdomyosarcoma, 2 s pindle cell sarcoma, 2 osteosarcoma, 1 leiomyosarcoma, 1 fibrosarcoma, and 1 chondrosarcoma. METHODS, In this report, immunohistochemical st ains, electron microscopy, and DNA flow cytometric analysis were perfo rmed on primary testicular sarcomas from three patients. RESULTS, The patients were age 47, 40, and 33 years. Each presented initially with a testicular mass. The tumors measured 4.8, 4.0, and 4.0 cm in greates t dimension. There were no associated germ cell elements nor elevated alpha-fetoprotein or beta-human chorionic gonadotropin. Case 1 was pos itive for actin, vimentin, and alpha-1-chymotrypsin. Case 2 was positi ve for vimentin but not desmin. Case 3 was positive for desmin and S-1 00. Smooth muscle differentiation was identified by electron microscop y. Flow cytometric analysis revealed DNA aneuploidy in all cases: 1.27 , 1.29, and 1.71. The 3 patients were alive and well without recurrent disease at 7, 6, and 4 years after diagnosis. Inguinal orchiectomy wa s the initial treatment in all 17 patients, there was 1 death from met astatic disease and 2 patients with distant metastases. CONCLUSIONS, P rimary testicular sarcoma is a rare indolent tumor with potential for distant metastases. Two cases of primary testicular leiomyosarcoma and one of unclassified sarcoma of the testis are reported. (C) 1996 Amer ican Cancer Society.