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Liposarcoma of the spermatic cord masquerading as an incarcerated inguinal hernia
J Matthew Hassan1, Susannah V Quisling, Willie V Melvin
1Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2765, USA.
Insights
This rare case highlights spermatic cord liposarcoma, often presenting as a painless lump. Misdiagnosis as a hernia is common, necessitating radical orchiectomy and potentially radiation therapy for aggressive tumors.
Area of Science:
- Urology
- Surgical Oncology
- Pathology
Background:
- Liposarcoma of the spermatic cord is an exceptionally rare malignancy.
- Fewer than 70 cases are documented in medical literature.
- Typical presentation involves a painless inguinal or scrotal mass.
Observation:
- The patient presented with acute inguinoscrotal swelling.
- Preoperative diagnosis was incarcerated indirect hernia.
- This highlights potential diagnostic challenges.
Findings:
- Spermatic cord liposarcoma requires radical orchiectomy with high cord ligation.
- Adjuvant radiation therapy is indicated for high-grade tumors, lymphatic invasion, positive margins, or recurrence.
- This case underscores the importance of considering rare differentials.
Implications:
- Accurate and timely diagnosis of spermatic cord liposarcoma is crucial for effective management.
- Surgical resection with appropriate oncological principles is the cornerstone of treatment.
- Further research into diagnostic modalities and treatment optimization for this rare tumor is warranted.
Abstract:
We present a rare case of liposarcoma of the spermatic cord. There are only 61 reports in the literature. The presenting complaint is usually a painless bulge in the inguinal or scrotal region. Our patient presented with a new-onset inguinoscrotal swelling that was misdiagnosed preoperatively as an incarcerated indirect hernia. The treatment for a spermatic cord liposarcoma is radical orchiectomy with high ligation of the cord. Radiation therapy is recommended in addition to surgery in situations with evidence of tumor with propensity for more aggressive behavior (i.e., high-grade tumor, lymphatic invasion, inadequate margin, or recurrence). The current literature, diagnosis, and management of malignant tumors of the spermatic cord are reviewed.
