# A rare case of giant intrascrotal rhabdomyosarcoma: A case report

## TL;DR

This paper presents a rare case of a large rhabdomyosarcoma in the scrotum of a 17-year-old male, emphasizing the importance of early diagnosis and treatment for better outcomes.

## Contribution

The paper adds to the limited literature on intrascrotal rhabdomyosarcoma in adolescents by presenting a detailed case report.

## Key findings

- A 17-year-old male presented with a 20×15 cm intrascrotal mass confirmed as rhabdomyosarcoma.
- Diagnosis relied on clinical, imaging, and histopathological findings, with tumor cells positive for desmin and myogenic markers.
- Early diagnosis and aggressive treatment are critical for reducing recurrence and improving survival in large tumors.

## Abstract

Rhabdomyosarcoma can develop at a variety of sites, including the mesenchymal elements of the spermatic cord, epididymis, and testicular envelopes, resulting in the development of a painless scrotal mass.

We report this case because very few cases of intrascrotal rhabdomyosarcomas have been reported, especially in adolescents and adults; hence, we hope that this will contribute to the understanding, diagnosis, and treatment of the disease among academic societies.

A 17-year-old male came with a 2-year history of progressive right scrotal swelling. There was a right testicular 20 × 15 cm mass.

Abdominopelvic CT-scan showed a huge, solid, and cystic enhancing right testicular mass.

Hematoxylin and eosin-stained histologic sections of the tumor showed highly cellular proliferation of pleomorphic spindle cells. Immunohistochemistry showed that the tumor cells are positive for desmin and myogenic.

The tumor mass was removed en bloc. The postoperative period was uneventful, and he was linked to the oncology department for subsequent evaluation and follow-up, but we could not find the patient's file at the oncology side to see his subsequent progress when we wrote this case report about one year later.

Intrascrotal rhabdomyosarcoma arises from mesenchymal components of the region and its diagnosis is based on a combination of clinical features, imaging findings, and histopathological features.

Primary testicular rhabdomyosarcoma is rare but has a poor prognosis, particularly in adolescents and tumors larger than 10 cm; therefore, early diagnosis and aggressive surgical treatment reduces the incidence of local recurrence and may improve the overall survival.

•Intratesticular and paratesticular rhabdomyosarcomas can develop from mesenchymal elements of the spermatic cord, epididymis, and testicular envelopes.•Para testicular rhabdomyosarcoma (RMS) is the most common non-germinal malignant tumor of the site.•The diagnosis of intrascrotal rhabdomyosarcoma (RMS) is based on the combination of clinical features, imaging findings, and histopathologic features.•Management of intrascrotal rhabdomyosarcoma encompasses surgery and chemotherapy, with or without radiation.

Intratesticular and paratesticular rhabdomyosarcomas can develop from mesenchymal elements of the spermatic cord, epididymis, and testicular envelopes.

Para testicular rhabdomyosarcoma (RMS) is the most common non-germinal malignant tumor of the site.

The diagnosis of intrascrotal rhabdomyosarcoma (RMS) is based on the combination of clinical features, imaging findings, and histopathologic features.

Management of intrascrotal rhabdomyosarcoma encompasses surgery and chemotherapy, with or without radiation.