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[A Case of Spermatic Cord Liposarcoma Difficult to Distinguish from Inguinal Hernia]
Hiromu Horitani1, Kentaro Takezawa1, Shinichiro Fukuhara1
1The Department of Urology, Osaka University Graduate School of Medicine.
Insights
A liposarcoma of the spermatic cord was initially misdiagnosed as an inguinal hernia. This case highlights the challenges in differentiating these conditions using imaging, emphasizing the need for careful evaluation.
Area of Science:
- Oncology
- Surgical Pathology
- Diagnostic Imaging
Background:
- Spermatic cord liposarcoma is a rare soft tissue tumor.
- Distinguishing spermatic cord liposarcoma from inguinal hernia on imaging can be challenging.
- Early diagnosis and appropriate management are crucial for patient outcomes.
Observation:
- A 53-year-old male presented with left inguinal enlargement, initially diagnosed as inguinal hernia via computed tomography (CT) scan.
- Intraoperative findings revealed an inguinal tumor, initially presumed to be lipoma, with incomplete resection.
- Follow-up CT revealed significant tumor growth, leading to a diagnosis of spermatic cord liposarcoma.
Findings:
- Histological examination confirmed a well-differentiated liposarcoma of the spermatic cord.
- The patient underwent wide excision of the tumor and treatment for hydrocele.
- Post-operative follow-up exceeding 10 months showed no evidence of recurrence.
Implications:
- This case underscores the diagnostic difficulty in differentiating spermatic cord liposarcoma from inguinal hernia using standard imaging techniques.
- Accurate preoperative diagnosis is essential for appropriate surgical planning and management of spermatic cord liposarcoma.
- Increased awareness and consideration of rare differentials like liposarcoma are important in managing inguinal masses.
Abstract:
A 53-year-old man visited a doctor due to left inguinal enlargement. He was diagnosed with left inguinal hernia with omentum as the content by a computed tomography (CT)scan. He underwent open inguinal hernia repair ; however, an inguinal tumor was diagnosed intraoperatively and was resected as much as possible. Although the tumor resection was macroscopically incomplete, he was followed up without any treatment because the tumor was histologically diagnosed as lipoma. Sixteen months after surgery, a 15 cm inguinal mass and a 7 cm left intrascrotal mass were detected by follow-up CT, and he was referred to our hospital. He underwent open surgery for wide excision of the tumor with a diagnosis of spermatic cord liposarcoma and left hydrocele of testis. The spermatic cord tumor was histologically diagnosed as well differentiated liposarcoma. He has been alive without recurrence for more than 10 months after surgery. It is sometimes difficult to distinguish a spermatic cord liposarcoma from inguinal hernia by imaging examinations.
