Malignant fibrous histiocytoma of the spermatic cord.

Abstract

We analyzed 26 cases of malignant fibrous histiocytoma and report our conclusions regarding the diagnosis, pathology and treatment of this unusual tumor. We reviewed 25 previously reported cases of malignant fibrous histiocytoma of the spermatic cord and report 1 additional case. Further data on patient survival and tumor recurrence rates were obtained from some of the previous authors. Of 26 patients 5 are long-term survivors (more than 5 years). 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 from metastatic tumor. Disease recurred in 5 patients. In no case was there local lymph node involvement at surgery. Malignant fibrous histiocytoma presents earlier in the spermatic cord than at other 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 necessary.