2022 Volume 61 Issue 1 Pages 22-28
Background : Liposarcomas of the spermatic cord are rare, and cytodiagnosis of this tumor can be challenging.
Case : A 71-year-old man visited our hospital with a painless swelling of the left scrotum. Under the suspicion of a paratesticular tumor, a high orchiectomy was performed. Macroscopically, we found a well-defined solid tumor in the spermatic cord, the cut-surface of which was whitish-yellow in color, with patchy areas of necrosis. Touch imprint smears of the tumor showed large, atypical cells arranged in loose sheets or dispersed individually, a substantial number of which contained bizarre multi-lobulated nuclei. Interestingly these atypical cells were surrounded by a large number of small lymphocytes, labelled as tumor-infiltrating lymphocytes (TILs). There were no atypical lipoblasts with multi-vacuolated cytoplasm. Immunohistochemistry and fluorescent in situ hybridization (FISH) of the surgical specimen showed MDM2 overexpression and amplification of the MDM2 gene locus (12q13-15), respectively. The findings suggested the diagnosis of dedifferentiated liposarcoma arising from the spermatic cord.
Conclusion : We report the interesting cytological features in a case of dedifferentiated liposarcoma with dense TIL infiltration ; this evidence of a tumor immune response might be suggestive of a better prognosis.
