[Paratesticular leiomyosarcoma. Review and update].

Objectives: To present one case of paratesticular leiomyosarcoma, a rare tumor which has been reported in 5 cases only in our country. To review the management of this type of tumor.

Methods: A 73-year-old male presenting with a 4 cm mass adjacent to the right testicle underwent excision of the mass, spermatic cord and testicle through an inguinal approach.

Results: The tumor was classified as a grade 3 leiomyosarcoma, with positive immunohistochemical staining for desmin and smooth muscle actin. After this pathology report we did not consider adjuvant oncological treatment. Tumor relapse has not appeared so far.

Conclusions: Radical surgery is the only feasible and successful treatment for paratesticular sarcomas, with the exception of rabdomyosarcoma, because they are radio and chemoresistant. The inguinal approach is the ideal and obligatory one, including excision of the spermatic cord and adjacent testicle. Long-term periodic follow-up visits are mandatory because relapses may occur even long time after diagnosis. In case of relapse, surgery is again the only tool we have to control this type of tumor. Currently radiotherapy is recommended in cases of local recurrence after surgery. 5-year survival rates are around 75%, and 10-year 50%.