Concordancia clínica y patológica en tumores conjuntivales: Análisis de 195 casos / Clinic-pathological agreement in the diagnosis of conjunctival tumours: Analysis of 195 cases

Propósito Evaluar la concordancia entre el diagnóstico clínico y patológico en tumores conjuntivales en una unidad especializada en oncología ocular. Métodos Estudio retrospectivo de pacientes consecutivos con tumores conjuntivales diagnosticados en la Unidad de Oncología Ocular del Hospital Universitario de Valladolid desde 1992 hasta 2017. Los tumores se clasificaron según su origen (epitelial, melanocítico, linfoide y otros) y grado de malignidad (benigno, premaligno, maligno). Se realizó biopsia en los casos de lesiones sintomáticas o en crecimiento. Como indicador de concordancia entre el diagnóstico clínico y el patológico se utilizo el estadístico kappa (κ) de Cohen. Resultados Cuatrocientos sesenta y dos pacientes fueron atendidos de manera consecutiva, requiriendo biopsia en 195 (42,2%). La concordancia con el diagnóstico anatomopatológico fue satisfactoria en 154 (79%) casos. El análisis según el grado de malignidad mostró la menor tasa de concordancia en las lesiones benignas (n = 83; 91,6%) y premalignas (n = 62; 90,3%), con una concordancia total en las lesiones malignas (n = 50; 100%); el valor κ fue de 0,90. Los mayores índices de concordancia se encontraron en las lesiones epiteliales, melanocíticas y de partes blandas, con valores κ de 1, 0,8 y 1 respectivamente. El peor índice de concordancia se observó en lesiones linfoides, con un valor κ de 0,3. Conclusiones La mayoría de los tumores conjuntivales fueron correctamente identificados clínicamente. Las lesiones benignas y malignas mostraron la mayor tasa de precisión; sin embargo, las lesiones premalignas pueden ocultar enfermedad microinvasiva que puede pasar desapercibida en el examen clínico. La biopsia es esencial para un diagnóstico y un tratamiento precisos (AU)

Purpose The present study aims to assess the agreement between clinical and pathological diagnosis in conjunctival tumours in a specialist ocular oncology unit. Methods A retrospective study of consecutive patients with conjunctival tumours diagnosed at the Ocular Oncology Unit of the University Hospital of Valladolid was performed from 1992 to 2017. Tumours were classified according to their origin (epithelial, melanocytic, lymphoid, and others) and degree of malignancy (benign, premalignant, and malignant). A biopsy was performed in cases of symptomatic or growing lesions. Cohen's kappa (κ) statistics was used as an indicator of agreement between clinical and pathological diagnosis. Results Of 462 consecutive patients, a biopsy was required in 195 (42.2%). The agreement with the pathological diagnosis was successful in 154 (79%) cases. Analysis according to the grade of malignancy showed the lowest rate of agreement among benign (n = 83; 91.6%) and premalignant (n = 62; 90.3%) lesions, with a total agreement in malignant lesions (n = 50; 100%); the Cohen's kappa coefficient (κ) was 0.90. The highest rates of concordance were found in epithelial, melanocytic and soft tissue lesions with κ values of 1, 0.8 and 1, respectively. The worst rate of concordance was found in lymphoid lesions with a κ value of 0.3. Conclusions Most of the conjunctival tumours were correctly identified clinically; benign and malignant lesions showed the highest rate of accuracy; however, premalignant tumours can hide micro-invasive diseases that can go unnoticed on clinical examination. The biopsy is essential for accurate diagnosis and treatment (AU)

Clinic-pathological agreement in the diagnosis of conjunctival tumours: Analysis of 195 cases.

PURPOSE: The present study aims to assess the agreement between clinical and pathological diagnosis in conjunctival tumours in a specialist ocular oncology unit. METHODS: retrospective study of consecutive patients with conjunctival tumours diagnosed at the Ocular Oncology Unit of the University Hospital of Valladolid was performed from 1992 to 2017. Tumours were classified according to their origin (epithelial, melanocytic, lymphoid and others) and degree of malignancy (benign, premalignant, malignant). A biopsy was performed in cases of symptomatic or growing lesions. Cohen´s kappa (κ) statistics was used as an indicator of agreement between clinical and pathological diagnosis. RESULTS: Of 462 consecutive patients, a biopsy was required in 195 (42.2%). The agreement with the pathological diagnosis was successful in 154 (79.0%) cases. Analysis according to the grade of malignancy showed the lowest rate of agreement among benign (n = 83; 91.6%) and premalignant (n = 62; 90.3%) lesions, with a total agreement in malignant lesions (n = 50; 100%); the Cohen´s kappa coefficient (κ) was 0.90. The highest rates of concordance were found in epithelial, melanocytic and soft tissue lesions with κ values of 1, 0.8 and 1 respectively. The worst rate of concordance was found in lymphoid lesions with a κ value of 0.3. CONCLUSION: Most of the conjunctival tumours were correctly identified clinically; benign and malignant lesions showed the highest rate of accuracy; however, premalignant tumours can hide micro-invasive diseases that can go unnoticed on clinical examination. The biopsy is essential for accurate diagnosis and treatment.

Intraocular metastasis as a systemic presentation of neuroendocrine differentiation of prostate carcinoma.

A 68 year-old male was referred for assessment of an amelanotic lesion in the right eye (RE) that was associated with a gradual loss of visual acuity (VA), of 2 months onset, as the main symptom. It was noted in his medical history, that 6 years ago, he had prostate cancer treated with prostatectomy, lymphadenectomy, and coadjuvant local radiotherapy (RT). He was asymptomatic until 6 months ago, when a metastasis was discovered in the left femur, which was treated with radiotherapy. There were no findings of interest in the left eye (LE). His AV was very low in his RE, and in the eye fundus examination a mass without pigment was observed in the posterior pole with an adjacent exudative retinal detachment. Due to his personal history and results of the complementary tests such as ultrasound and magnetic resonance, the most likely diagnostic option was metastasis of prostate carcinoma, subsequently being confirmed with the histopathology results. Despite 4 cycles of chemotherapy, the patient did not show any clinical or radiological response, worsening until his death 3 months later.

Metástasis intraocular como presentación sistémica de un adenocarcinoma de próstata con diferenciación neuroendocrina / Intraocular metastasis as a systemic presentation of neuroendocrine differentiation of prostate carcinoma

Varón de 68 años derivado para valoración de una lesión amelanótica en el ojo derecho (OD) que asociaba como síntoma principal pérdida de agudeza visual (AV) progresiva de 2 meses de evolución. Entre sus antecedentes destaca un adenocarcinoma de próstata tratado con prostatectomía, linfadenectomía y radioterapia local (RT) coadyuvante hace 6 años. Asintomático hasta hace 6 meses, cuando se descubrió una metástasis en fémur izquierdo, tratada con radioterapia. La exploración del ojo izquierdo (OI) no tenía hallazgos de interés. En el OD su AV era muy baja y en el fondo de ojo (FO) se encontró una masa sin pigmento en polo posterior con un desprendimiento de retina (DdR) exudativo adyacente. Por sus antecedentes personales y características de las pruebas complementarias como ecografía o resonancia, la opción diagnóstica más probable era metástasis de adenocarcinoma de próstata, certificándose posteriormente con los resultados anatomopatológicos. A pesar de los 4 ciclos de quimioterapia (QT) recibidos, el paciente no obtuvo respuesta clínica ni radiológica, empeorando hasta su fallecimiento 3 meses después (AU)

A 68 year-old male was referred for assessment of an amelanotic lesion in the right eye (RE) that was associated with a gradual loss of visual acuity (VA), of 2 months onset, as the main symptom. It was noted in his medical history, that 6 years ago, he had prostate cancer treated with prostatectomy, lymphadenectomy, and coadjuvant local radiotherapy (RT). He was asymptomatic until 6 months ago, when a metastasis was discovered in the left femur, which was treated with radiotherapy. There were no findings of interest in the left eye (LE). His VA was very low in his RE, and in the eye fundus examination a mass without pigment was observed in the posterior pole with an adjacent exudative retinal detachment. Due to his personal history and results of the complementary tests such as ultrasound and magnetic resonance, the most likely diagnostic option was metastasis of prostate carcinoma, subsequently being confirmed with the histopathology results. Despite 4 cycles of chemotherapy, the patient did not show any clinical or radiological response, worsening until his death 3 months later (AU)

Revisión retrospectiva del melanoma conjuntival: presentación, tratamiento y evolución / A retrospective review of conjunctival melanoma: Presentation, treatment and evolution

Objetivo: Describir las características clínicas y la evolución de los pacientes diagnosticados y tratados de melanoma conjuntival en la Unidad de Tumores del Hospital Clínico Universitario de Valladolid. Métodos: Estudio retrospectivo; se incluyeron pacientes diagnosticados consecutivamente de melanoma conjuntival desde enero de 1992 hasta diciembre de 2017. La información demográfica y las características del tumor fueron registradas en una base de datos en Microsoft Access. Resultados: De un total de 462 pacientes con diagnóstico de tumor conjuntival, 252 casos (54,5%) fueron de origen melanocítico, y de estos, 27 casos fueron melanomas de conjuntiva. La edad media fue de 59,2 (16-88) años; 41% hombres y 59% mujeres, con un seguimiento medio de 6,1 ± 6,8años. Según el origen del melanoma conjuntival, 16 casos (59%) surgieron a partir de melanosis adquirida primaria, el 26% de nevus y el 15% de novo. Se realizó biopsia incisional o escisional en todos los pacientes, quimioterapia local adyuvante en 15 casos (56%) y braquiterapia en 5 pacientes (18%). La supervivencia media fue de 18 años (IC95%) y la probabilidad de supervivencia a los 5 y 10 años fue del 89 y del 69%, respectivamente. Conclusiones: El melanoma conjuntival es una enfermedad rara que se suele infravalorar en estadios iniciales, lo que lleva a un tratamiento insuficiente y tardío. El diagnóstico y el tratamiento precoces son esenciales para prevenir las recurrencias y la extensión sistémica y para preservar la visión y la vida del paciente

Objective: The purpose of the present study is to describe the clinical characteristics and outcomes of patients diagnosed and treated for conjunctival melanoma in the Ocular Oncology Unit of the University Hospital Clinic of Valladolid. Methods: A retrospective observational case series study was conducted on patients diagnosed with conjunctival melanoma in the Ocular Oncology Unit of University Hospital Clinic of Valladolid, from January 1992 to December 2017. Demographic information and tumour features were recorded in a Microsoft Access database. Results: Among a total of 462 consecutive patients, the tumour was classified as melanocytic in 252 cases (54.5%), with 27 patients having the pathological diagnosis of conjunctival melanoma. The mean age at diagnosis was 59.2 years (16-88), and there were 41% males and 59% females, with a mean follow-up of 6.1 ± 6.8 years. As regards the origin of conjunctival melanoma, 16 cases (59%) arose from primary acquired melanosis, 26% from nevus, and 15% developed de novo. The treatment performed was incisional or excisional biopsy in all patients, local adjuvant chemotherapy in 15 cases (56%) and brachytherapy in 5 patients (18%). The median survival was 18 years and the probability of survival at 5 and 10 years was 89% and 69%, respectively. Conclusions: Conjunctival melanoma is a rare disease, usually undervalued by the patient as well as being underdiagnosed, leading to insufficient and delayed treatment. Early diagnosis and treatment are essential to prevent recurrences and systemic extension, as well as to preserve vision and life

A retrospective review of conjunctival melanoma: Presentation, treatment and evolution. / Revisión retrospectiva del melanoma conjuntival: presentación, tratamiento y evolución.

OBJECTIVE: The purpose of the present study is to describe the clinical characteristics and outcomes of patients diagnosed and treated for conjunctival melanoma in the Ocular Oncology Unit of the University Hospital Clinic of Valladolid. METHODS: A retrospective observational case series study was conducted on patients diagnosed with conjunctival melanoma in the Ocular Oncology Unit of University Hospital Clinic of Valladolid, from January 1992 to December 2017. Demographic information and tumour features were recorded in a Microsoft Access database. RESULTS: Among a total of 462 consecutive patients, the tumour was classified as melanocytic in 252 cases (54.5%), with 27 patients having the pathological diagnosis of conjunctival melanoma. The mean age at diagnosis was 59.2years (16-88), and there were 41% males and 59% females, with a mean follow-up of 6.1±6.8years. As regards the origin of conjunctival melanoma, 16 cases (59%) arose from primary acquired melanosis, 26% from nevus, and 15% developed de novo. The treatment performed was incisional or excisional biopsy in all patients, local adjuvant chemotherapy in 15 cases (56%) and brachytherapy in 5 patients (18%). The median survival was 18years and the probability of survival at 5 and 10years was 89% and 69%, respectively. CONCLUSIONS: Conjunctival melanoma is a rare disease, usually undervalued by the patient as well as being underdiagnosed, leading to insufficient and delayed treatment. Early diagnosis and treatment are essential to prevent recurrences and systemic extension, as well as to preserve vision and life.

Metástasis intraoculares: comparación entre las formas de presentación clínica con tumor primario conocido y desconocido / Intraocular metastasis: comparison of clinical presentation with a known and unknown primary tumour

OBJETIVO: El objetivo del presente estudio es revisar la frecuencia de metástasis intraoculares como primera manifestación de enfermedad sistémica e identificar las características clínicas y tumorales. MÉTODOS: Estudio retrospectivo y consecutivo de casos diagnosticados como metástasis intraoculares en una unidad de referencia de tumores intraoculares entre 1993 y 2014. Se registraron las características generales, epidemiológicas y oftalmológicas. RESULTADOS: Entre 1993 y 2014, se diagnosticaron 21 pacientes con metástasis intraoculares. Edad media de 62,7 años (31-89). Se observó bilateralidad en 4 casos y localización coroidea en 20 casos. El tumor intraocular fue la primera manifestación de la enfermedad sistémica en 13 pacientes (61,9%). El tumor primario fue la mama en el 47,5% de los casos y el pulmón en el 23,8%. El diagnóstico del tumor primario se realizó mediante estudios sistémicos y solo un paciente requirió biopsia intraocular. Respecto al tratamiento, la mayoría de los casos se controlaron mediante terapia sistémica; 4 casos precisaron radioterapia externa adicional y solamente un caso, enucleación. No se encontraron diferencias clínicas entre los casos de cáncer sistémico conocido o desconocido, excepto respecto al desprendimiento de retina exudativo, más frecuente en el segundo grupo. CONCLUSIONES: Aunque las metástasis intraoculares son el tumor intraocular más frecuente, no son un motivo frecuente de consulta. En más de la mitad de los casos es la forma de presentación de una neoplasia sistémica desconocida como una masa intraocular solitaria no pigmentada. El diagnóstico precoz es crucial para establecer el tratamiento adecuado, preservar la función visual y mejorar el pronóstico vital del paciente

OBJECTIVE: The purpose of the present study is to review the frequency of intraocular metastases as first presentation of systemic disease, and to identify clinical and tumour characteristics. METHODS: Retrospective study of consecutive cases diagnosed of intraocular metástasis at a referral intraocular tumours unit between 1993 and 2014. General, epidemiological and ophthalmological characteristics were recorded. RESULTS: A total of 21 patients, with a mean age 62.7 years (31-89) were diagnosed with intraocular metástasis between 1993 and 2014. Both eyes were affected in 4 cases. Location was choroid in 20 cases. The intraocular tumour was the first manifestation of the systemic disease in 13 patients (61.9%). Primary tumour was breast in 47.6% and lung in 23.8%. Diagnosis of the primary tumour was performed by systemic studies, and only 1 patient required intraocular biopsy. Regarding the treatment, the majority of cases were controlled with systemic therapy, with 4 cases requiring additional external beam radiotherapy, and only one enucleation. No clinical differences were found between the cases with known and unknown systemic neoplasia, except in exudative retinal detachment, which was more frequent in the second group. CONCLUSIONS: Although intraocular metastases are the most frequent intraocular tumour, they are not a frequent cause of consultation. In more than half of the cases it is the first presentation of unknown systemic neoplasia as a solitary non-pigmented intraocular mass. Early diagnosis is crucial to establish the appropriate treatment, preserve visual function, and improve the prognosis of the patient

Intraocular metastasis: comparison of clinical presentation with a known and unknown primary tumour. / Metástasis intraoculares: comparación entre las formas de presentación clínica con tumor primario conocido y desconocido.

OBJECTIVE: The purpose of the present study is to review the frequency of intraocular metastases as first presentation of systemic disease, and to identify clinical and tumour characteristics. METHODS: Retrospective study of consecutive cases diagnosed of intraocular metástasis at a referral intraocular tumours unit between 1993 and 2014. General, epidemiological and ophthalmological characteristics were recorded. RESULTS: A total of 21 patients, with a mean age 62.7 years (31-89) were diagnosed with intraocular metástasis between 1993 and 2014. Both eyes were affected in 4 cases. Location was choroid in 20 cases. The intraocular tumour was the first manifestation of the systemic disease in 13 patients (61.9%). Primary tumour was breast in 47.6% and lung in 23.8%. Diagnosis of the primary tumour was performed by systemic studies, and only 1 patient required intraocular biopsy. Regarding the treatment, the majority of cases were controlled with systemic therapy, with 4 cases requiring additional external beam radiotherapy, and only one enucleation. No clinical differences were found between the cases with known and unknown systemic neoplasia, except in exudative retinal detachment, which was more frequent in the second group. CONCLUSIONS: Although intraocular metastases are the most frequent intraocular tumour, they are not a frequent cause of consultation. In more than half of the cases it is the first presentation of unknown systemic neoplasia as a solitary non-pigmented intraocular mass. Early diagnosis is crucial to establish the appropriate treatment, preserve visual function, and improve the prognosis of the patient.

Linfoma folicular primario de la conjuntiva simulando conjuntivitis crónica / Primary conjunctival follicular lymphoma mimicking chronic conjunctivitis

CASO CLÍNICO: Paciente varón de 43 años con conjuntivitis folicular crónica resistente a tratamiento local, y serologías para bacterias negativas. Se realizó biopsia incisional que fue compatible con hiperplasia reactiva linfoide. Un año después, una nueva biopsia mostró un linfoma folicular, sin afectación sistémica, que fue tratado con radioterapia local. DISCUSIÓN: Ante una conjuntivitis folicular crónica resistente a tratamiento convencional es esencial realizar una biopsia incisional para el diagnóstico histopatológico, que puede abarcar desde la inflamación crónica y la hiperplasia reactiva linfoide al linfoma. El linfoma folicular es raro entre los linfomas de conjuntiva y la estadificación es indispensable para un correcto abordaje terapéutico

CLINICAL CASE: The case is presented of a 43 year-old male patient with chronic follicular conjunctivitis, negative bacterial serology, and refractory to local treatment. The incisional biopsy performed showed to be consistent with reactive lymphoid hyperplasia. A year later, a new incisional biopsy showed follicular lymphoma, with no systemic involvement, and he was treated with local radiotherapy. DISCUSSION: When a chronic follicular conjunctivitis is refractory to treatment, it is essential to perform an incisional biopsy to establish the histopathological diagnosis that can range from chronic inflammation, reactive lymphoid hyperplasia to lymphoma. Follicular lymphoma is rare among conjunctival lymphomas, and the staging is indispensable for the correct therapeutic approach

Primary conjunctival follicular lymphoma mimicking chronic conjunctivitis.

CLINICAL CASE: The case is presented of a 43 year-old male patient with chronic follicular conjunctivitis, negative bacterial serology, and refractory to local treatment. The incisional biopsy performed showed to be consistent with reactive lymphoid hyperplasia. A year later, a new incisional biopsy showed follicular lymphoma, with no systemic involvement, and he was treated with local radiotherapy. DISCUSSION: When a chronic follicular conjunctivitis is refractory to treatment, it is essential to perform an incisional biopsy to establish the histopathological diagnosis that can range from chronic inflammation, reactive lymphoid hyperplasia to lymphoma. Follicular lymphoma is rare among conjunctival lymphomas, and the staging is indispensable for the correct therapeutic approach.

Penile metastasis from primary bladder tumour.

OBJECTIVE: We present a case of cutaneous metastasis caused by a bladder tumor. METHODS: 68 year old male, diagnosed with an ISUP high grade urothelial carcinoma, affecting the whole bladder wall, including the perivesicular fat and macroscopic metastasis in the left ilio-obturator chain (T3N2MO), who presents painless induration on the dorsal surface of the glans penis with non-exudative ulcerated areas, evolving over several months. Given the negative serology result, the lesion was biopsied for anatomopathological study. RESULTS: The histopathological study of the lesion corresponded to a cutaneous metastasis from high grade urothelial carcinoma. CONCLUSION: Approximately 370 cases of penile metastasis have been described and the primary tumor is located in the bladder in 30-35% of them. Presentation of these lesions is very heterogeneous and requires anatomopathological study of the lesion for definitive diagnosis.

Técnica combinada de vitrectomía con biopsia y citología en el diagnóstico de tumor intraocular / Combined choroidal biopsy and cytology for diagnosis of intraocular tumour

Caso clínico: Ninguna técnica de biopsia intraocular es inocua y todas tienen posibilidad de falsos negativos por la dificultad para obtener una muestra suficiente. Paciente con sospecha de melanoma tras biopsia negativa con vitrectomía 25 G. Se realiza biopsia coriorretiniana modificada en la que además de extraerse un fragmento mediante cirugía bimanual, se obtiene material de la lesión con vitreotomo para realizar citología, confirmando el diagnóstico de sospecha de melanoma de coroides. Discusión: La asociación de una citología obtenida con vitreotomo de una lesión coroidea asociada a la escisión de un fragmento de la lesión puede mejorar la eficacia de la biopsia intraocular (AU)

Clinical case: No intraocular biopsy technique is free of risk and all have the possibility of giving false negatives due to the difficulty in obtaining a sufficient sample. A modified chorioretinal biopsy was performed on a patient with suspected choroidal melanoma after negative biopsy with 25G vitrectomy. In addition to removing a solid fragment of tumor material using bimanual surgery, material from the lesion was obtained with the vitreotome to perform cytology, which confirmed the diagnosis of melanoma. Discussion: Cytology obtained through the vitreotome in association with removing a solid sample of the choroidal lesion may improve the efficiency of intraocular biopsy (AU)

[Combined choroidal biopsy and cytology for diagnosis of intraocular tumour]. / Técnica combinada de vitrectomía con biopsia y citología en el diagnóstico de tumor intraocular.

CLINICAL CASE: No intraocular biopsy technique is free of risk and all have the possibility of giving false negatives due to the difficulty in obtaining a sufficient sample. A modified chorioretinal biopsy was performed on a patient with suspected choroidal melanoma after negative biopsy with 25G vitrectomy. In addition to removing a solid fragment of tumor material using bimanual surgery, material from the lesion was obtained with the vitreotome to perform cytology, which confirmed the diagnosis of melanoma. DISCUSSION: Cytology obtained through the vitreotome in association with removing a solid sample of the choroidal lesion may improve the efficiency of intraocular biopsy.

Composite anatomical-clinical-molecular prognostic model in non-small cell lung cancer.

The objective of the present study was to elaborate a survival model that integrates anatomic factors, according to the 2010 seventh edition of the tumour, node and metastasis (TNM) staging system, with clinical and molecular factors. Pathologic TNM descriptors (group A), clinical variables (group B), laboratory parameters (group C) and molecular markers (tissue microarrays; group D) were collected from 512 early-stage nonsmall cell lung cancer (NSCLC) patients with complete resection. A multivariate analysis stepped supervised learning classification algorithm was used. The prognostic performance by groups was: areas under the receiver operating characteristic curve (C-index): 0.67 (group A), 0.65 (Group B), 0.57 (group C) and 0.65 (group D). Considering all variables together selected for each of the four groups (integrated group) the C-index was 0.74 (95% CI 0.70-0.79), with statistically significant differences compared with each isolated group (from p = 0.006 to p < 0.001). Variables with the greatest prognostic discrimination were the presence of another ipsilobar nodule and tumour size > 3 cm, followed by other anatomical and clinical factors, and molecular expressions of phosphorylated mammalian target of rapamycin (phospho-mTOR), Ki67cell proliferation index and phosphorylated acetyl-coenzyme A carboxylase. This study on early-stage NSCLC shows the benefit from integrating pathological TNM, clinical and molecular factors into a composite prognostic model. The model of the integrated group classified patients with significantly higher accuracy compared to the TNM 2010 staging.

[Malignant fibrous histiocytoma of the spermatic cord. Presentation of one case and literature revision]. / Histiocitoma fibroso maligno de cordón espermático. Presentación de un caso y revisión de la literatura.

We present a case of malignant fibrous histiocytoma (MFH) of the spermatic cord. An 80-years-old man was admitted to the hospital with a left scrotal mass, related to a genital traumatism several months ago. Under the suspicion of a testicular tumor, left radical orchiectomy was performed. Histological examination of the tumoral mass revealed a malignant fibrous histiocytoma. The tumor was firmly adhered to the spermatic cord. MFH is an extremely rare, highly malignant connective tissue tumor, which may, occasionally, affect the male genital tract. There are no agreed treatment principles. The overall prognosis is poor.

Histiocitoma fibroso maligno de cordón espermático. Presentación de un caso y revisión de la literatura / Malignant fibrous histiocytoma of the spermatic cord. Presentation of one case and literature revision

Presentamos un caso de un histiocitoma fibroso maligno (HFM) de cordón espermático. Un varón de 80 años fue admitido en nuestro hospital con una masa escrotal izquierda, relacionada con un traumatismo genital hacia varios meses. Ante la sospecha de un tumor testicular, se practicó una orquiectomia radical izquierda. El examen histológico de la masa tumoral, reveló un Histiocitoma fibroso maligno. El tumor estaba firmemente adherido al cordón espermático. El HFM es un tumor de alta malignidad derivado del tejido conectivo, el cual puede ocasionalmente, afectar al tracto genital masculino. No hay acuerdo respecto a un tratamiento principal y el pronóstico en general, es pobre (AU)

We present a case of malignant fibrous histiocytoma (MFH) of the spermatic cord. An 80-years old man was admitted to the hospital with a left scrotal mass, related to a genital traumatism several months ago. Under the suspicion of a testicular tumor, left radical orchiectomy was performed. Histological examination of the tumoral mass revealed a malignant fibrous histiocytoma. The tumor was firmly adhered to the spermatic cord. MFH is an extremely rare, highly malignant connective tissue tumor, which may, occasionally, affect the male genital tract. There are no agreed treatment principles. The overall prognosis is poor (AU)