Rhabdomyosarcoma of the Spermatic Cord (Funiculus Spermaticus)

Abstract

Only a few reports of rhabdomyoma of the spermatic cord have appeared, to which may be added some descriptions appearing incidentally in publications dealing with related subjects. In some of the recorded cases the tumors have been situated so near the testis that they have invaded the latter structure and it has been difficult to determine whether the neoplasm originated in the testis or in the cord. The decision rests upon the structural components of the neoplasm, among which may be variable amounts of striated muscle tissue. An analysis of the recorded case reports is further complicated when an attempt is made to classify the relatively pure skeletal muscle tumors into benign and malignant growths. Review of Previously Reported Cases Rokitansky's report (7) of a spermatic cord rhabdomyoma in 1849 is the first published account of these skeletal muscle tumors. This growth, removed from a youth aged eighteen years, had in about four months attained the size of a goose egg. The mass was elastic and fleshy, and lay alongside of the testis, although grown into the tunica albuginea. The main portion consisted of muscle fibers resembling myocardium or, as Rokitansky (8) stated later, the tissues of the embryonal heart. Neumann (5) in 1886 described a tumor, the size of a walnut, which had been observed in the left side of the scrotum of a boy of three and a half years, for only a few months. The tumor was attached to the lower pole of the testis, and the testis and epididymis were unchanged. A portion of the mass bulged into the vaginal sac. The tumor contained cross-striated muscle fibers and multinucleated protoplasmic masses without cross striations. The latter resembled skeletal muscle fibers with waxy degeneration. In the case reported by Arnold (1) involvement of the testis by the rhabdomyoma was much more extensive. This tumor, removed from a boy aged four years, measured 10 by 7.5 by 4.5 cm. after alcohol fixation. Nothing of the right testis and only the caput of the epididymis remained. The essential tissues in the tumor were fibrils with more or less distinct cross striations. The cells contained an abundance of glycogen granules.