Radiologic and pathologic features of a primary chloroma of the testis: a case report and brief review of the literature.

AIM: To describe a case of primary granulocytic sarcoma.

CASE DESCRIPTION: A 43-year-old man presented with a painless testicular swelling. There was no previous history of malignancy or hematologic disease. Ultrasound and magnetic resonance imaging examination showed an intratesticular mass extending to the surrounding scrotal tissues including the epididymis. Inguinal radical orchiectomy was followed by a macroscopic and microscopic evaluation of the tumor. Immunohistochemistry demonstrated the strong positivity of the neoplastic cells for leucocyte common antigen (LCA), myeloperoxidase, CD-34 and CD-117. All imaging and laboratory tests for metastatic or hematologic disease, including a bone marrow biopsy, were negative, leading to the diagnosis of a primary granulocytic sarcoma of the testis.

CONCLUSION

Although chloromas usually manifest in patients with a hematologic malignancy, isolated cases may occur. The low specificity of imaging and, occasionally, microscopic examination is challenging for the right diagnosis. The role of immunohistochemistry in conjunction with the clinical, imaging and laboratory findings is crucial to reach the correct diagnosis.