Rhabdomyosarcoma of the Testis

One of the rarest varieties of intrascrotal neoplasm is a tumor composed of striated muscle. Only a few cases have been published and most of these appear as isolated reports in the older foreign literature. In many cases, the tumor was closely connected with the testicle, but it was difficult to determine whether it arose from the testis or from the adjacent tissue. Rokitansky in 1849 described a paratesticular tumor in an eighteen-yearold boy. The growth, which was composed entirely of skeletal muscle, he interpreted as having arisen from the gubernaculum of Hunter. Senftleben in 1858 described the presence of striated muscle bundles in a well differentiated teratoma of the testis. Neumann in 1886 reported a pure rhabdomyoma in a boy three and one-half years of age. The tumor was attached to the lower pole of the testis and was composed of striated muscle fibers and large muscle cells without striations. The testis and epididymis were unchanged. Like Rokitansky, Neumann thought that the tumor arose from the gubernaculum. Kocher in 1887 collected six cases of mixed tumors of the testis containing striated muscle. In 1890 Arnold reported a large tumor of the right testis, in a boy four years of age, largely composed of myomatous tissue with fairly distinct cross striations. In the outer portion were epithelial-lined canals. No remnant of testicular tissue could be found. Ribbert in 1892, in a general article on rhabdomyomas of the urogenital tract, reported three rhabdomyomas involving the testis. In the first patient, a boy of thirteen years, only a remnant of testicular tissue remained. In the second, a boy of fourteen years, the diagnosis was at first myxosarcoma, but later careful examination showed the presence of striated muscle. In the third case, in addition to striated muscle, there were carcinomatous and sarcomatous structures. Picque in 1898 presented a case of testicular tumor that was examined histologically by Chevassu. Fibrous tissue, smooth muscle, blood vessels, and epithelial glandular tissue were found, as well as striated muscle. Becker in 1901 reported a bilateral tumor of the testis. The tumors contained muscle fibers, large epithelial canals, mucous plugs, and many blood vessels. Wood in 1902, in this country, described a rhabdomyoma in a boy of eighteen, completely replacing the testicle. The remains of the testicle and epididymis were still to be found near the periphery. Microscopically, this tumor contained embryonic muscle, some of which showed cross striations, cartilage, and epithelial canals. Benenati in 1903 described a rhabdomyoma in an undescended testicle of