Extraskeletal Osteosarcoma of the spermatic cord - A rare entity masquerading as an inguinal swelling - A case report

Extraskeletal osteosarcoma is a rare mesenchymal malignancy of soft tissue, histologically similar to primary osteosarcoma of bone. This article is a case report of a rare extraskeletal osteosarcoma of the spermatic cord which presented like a benign inguinal swelling and later histopathologically turned out to be an extraskeletal osteosarcoma. Literature discusses this entity as a rare occurrence. There are differences from osteogenic osteosarcoma in demographics, imaging features, prognosis and management. Extraskeletal osteosarcoma occurs in older age group and usually presents as a soft-tissue mass, most commonly in the extremities and in particular the thigh. Imaging characteristics are nonspecific and reflect the morphology of the tumour. Osteoid matrix when present greatly aids diagnosis, although it is seen in only fifty percent of the cases. Metastases may or may not show mineralization despite the presence of mineralization in the primary tumour. Treatment options of this condition includes surgical removal of the tumour and adjuvant chemotherapy is not really known to be of help as the tumour itself is not very chemosensitive. The overall prognosis is poor, with local recurrence and metastases occurring being common. Our patient has undergone surgery and adjuvant chemotherapy. He is on regular follow up and his post-operative follow up CT scans showed stable findings and the patient is clinically asymptomatic.