Dedifferentiated Liposarcoma of the Epididymis: A Rare Case Report and Analysis

Dedifferentiated liposarcoma is a rare type of mesenchymal sarcoma. Although most cases occur in the retroperitoneum or extremities, this report presents a rare case of dedifferentiated liposarcoma in the epididymis, highlighting the diverse sites where this disease may manifest and emphasizing the diagnostic challenges it poses, as well as the importance of comprehensive imaging and histopathological assessment.

A 70-year-old Chinese male patient presented to the urology department with progressive left scrotal enlargement, pain, and a palpable firm mass over the past month. After admission, initial ultrasound examination indicated a left spermatic cord mass. Subsequently, an enhanced MRI was performed, revealing no obvious fat signal within the lesion but significant enhancement, with thickening and compression of the spermatic cord. The findings ultimately suggested a malignant sarcoma of the left epididymis. Surgical resection and subsequent histopathological examination confirmed a spindle cell-predominant dedifferentiated liposarcoma of the epididymis encircling the spermatic cord. After 11 months of follow-up, no recurrence has been detected.

We report a surgically confirmed rare case of dedifferentiated liposarcoma originating from the epididymis, characterized by predominant spindle cells and significant imaging enhancement. This atypical presentation complicated differentiation from other spindle cell sarcomas, highlighting diagnostic challenges at rare sites.