Para-testicular rhabdomyosarcoma is a rare and aggressive malignancy that primarily affects children and adolescents, with peak incidence between two and five years of age. Among its histological variants, the spindle cell type is exceptionally uncommon, accounting for roughly 5% of cases. Because these tumors grow quickly and often produce non-specific symptoms, early diagnosis is essential to improving survival and reducing the risk of recurrence.

The patient, a 17-year-old male, presented with scrotal swelling following trauma. Ultrasound revealed a large hypoechoic mass in the left hemiscrotum, and a left radical orchiectomy was performed. Histopathology showed a spindle cell tumor; immunohistochemistry was positive for skeletal muscle markers including myogenin, MyoD1, desmin, vimentin and actin, and molecular testing identified an NRAS Q61L mutation—findings that secured the diagnosis. Staging imaging then revealed an enlarged left para-aortic lymph node and a small pleural nodule.

Together, these results shaped a multimodal treatment plan: the patient was scheduled for three cycles of chemotherapy as initial management, with regular follow-up and imaging surveillance. As the authors emphasize, spindle cell rhabdomyosarcoma demands prompt recognition and intervention to reduce morbidity and mortality. This case underscores the importance of accurate assessment, rigorous pathological and molecular characterization, and coordinated multimodal care in minimizing recurrence risk for an exceptionally rare tumor.

The work titled “Diagnostic and therapeutic approaches of para‐testicular SCRMS in an adolescent patient: A case report” was published in UroPrecision (published on August 1, 2025).
DOI: 10.1002/uro2.70027