Delayed Diagnosis of a Testicular Mass During COVID-19 Pandemic in Lombardy: A Case Report

Miriam Cieri,1 Roberto Contieri,2,3 Camilla De Carlo,1,3 Giovanni Lughezzani,2,3 Davide Maffei,2,3 Piergiuseppe Colombo1 1Department of Pathology, Humanitas Clinical and Research Center – IRCCS, Milan, Italy; 2Department of Urology, Humanitas Clinical and Research Center – IRCCS, Milan, Italy; 3Department of Biomedical Sciences, Humanitas University, Milan, ItalyCorrespondence: Piergiuseppe ColomboDepartment of Pathology, Humanitas Clinical and Research Center – IRCCS, Via Manzoni 56, Rozzano, Milan CAP 20089, ItalyEmail piergiuseppe.colombo@humanitas.itAbstract: Signs and symptoms associated with testicular and paratesticular structures should not be underestimated because they may hide diseases requiring immediate evaluation and treatment, such as germline tumors or sarcomas, with the latter histotypes being more common among elderly patients. Unfortunately, the COVID-19 pandemic in Italy has led to a diagnostic delay of several malignancies and the impact of this delay has likely been underestimated. Paratesticular leiomyosarcoma represents a very rare subtype of sarcoma. Here we describe a 57-year-old man who presented to the emergency department with dyspnea and a voluminous mass in the right paratesticular region. At the appearance of the scrotal mass 9 months prior, he had refused to undergo a urological evaluation due to fear of contracting COVID-19. We present this case for its histological rarity and to document a case of diagnostic and therapeutic delay during the pandemic in Lombardy.Keywords: COVID-19, leiomyosarcoma, mass of the testis, diagnostic delay, pandemic