AGGRESSIVE FIBROMATOSIS OF THE SPERMATIC CORD - A TYPICAL LESION IN ANEW LOCATION

The authors describe a 31-year-old man with a 7 cm aggressive fibromat osis (desmoid tumor) of the spermatic cord presenting as a swelling in the left inguinal area that was excised along with the testis and cor d. The desmoid tumor is histologically typical, but such tumors arisin g primarily from the paratesticular structures have apparently not bee n previously reported and the diagnosis would not be questioned if it not for the unusual site. This tumor is histologically and immunohisto chemically indistinguishable from abdominal wall desmoid tumor, with o r without Gardner's syndrome. Desmoid tumors at this location should b e distinguished from reactive processes, such as pseudosarcomatous myo fibroblastic proliferation (so-called ''proliferative funiculitis'') a nd inflammatory fibrous pseudotumor, all of which exhibit fibroblastic /myofibroblastic differentiation. Paratesticular fibrosarcoma and leio myosarcoma should also be differentiated from desmoid tumor that does not have the metastatic potential of sarcomas. Thirty-four months post -operatively, an 8 cm local recurrence in the remaining portion of the left vas deferens causing left hydroureter and hydronephrosis was det ected.