LIPOSARCOMA OF SPERMATIC CORD PRESENTING AS INDIRECT INGUINAL HERNIA- A RARE CASE REPORT

Abstract

Liposarcoma in the inguinal region though rare are clinically significant lesions. Preoperative diagnosis is difficult since the clinical findings are very similar to that of inguinal hernia. We report a rare case of Liposarcoma of the spermatic cord in 85 year old male, clinically diagnosed as left sided indirect inguinal hernia. Surgical excision specimen showed multiple globular lipomatous masses which were yellowish and grey tan with areas of myxoid degeneration and necrosis seen. Microscopic examination showed adipocytes arranged in lobules with numerous blood vessels, lipoblasts and myxoid stroma confirming the diagnosis of myxoid liposarcoma. He is on regular follow up since two years without any recurrence or metastasis. Our case report highlights the importance of sampling and examination of fatty masses in the inguinal region to rule out the possibility of liposarcoma as they are mistaken for lipoma at surgery.

Keywords

Liposarcoma - spermatic cord - indirect inguinal hernia

• References

• 1 Alejandro Garcia Morna, Juan Fermin Lozano Salinas, Federico Valdes Sepulveda, Homero Zapata, Lauro Salvador Gomez Guerra. Liposarcoma of the Spermatic cord; our experience and a literature review. Actas Urologicas Espanolas 2009; 33:811-5.
• 2 Channara Sookluan. Giant Retroperitoneal Liposarcoma Presenting as Indirect Inguinal Hernia. J Parpokklao Hosp Clin Med Educat Center 2006; 22:151-7.
• 3 Hirofumi N, Yoshio N, Minoru H, Tomoki Y, Kaori S, Hirokazu U ,et al, Retroperitoneal Liposarcoma Presenting a Indirect Inguinal Hernia. Acta Med. Okayama 2001; 55:51-4.
• 4 Elizabeth Montgomery, Cyril Fisher. Paratesticular Liposarcoma- Clinicopathologic Study. American Journal of Surgical Pathology 2003; 27:40-7.
• 5 Elizabeth Montgomery, Robert Buras. Incidental Liposarcomas identified during Hernia repair operations. Journal of Surgical Oncology 1999; 71:503.
• 6 Panagis A, Karydas G, Vasilakakis J, Chatzipaschalis E, Lambropoulou M, Papadopoulos N. Myxoid Liposarcoma of the Spermatic Cord: A Case Report and review of the literature. Int Urol Nephrol 2003; 35:369-72.
• 7 Hirofumi Noguchi, Yoshio Naomoto, Minoru Haisa, Tomoki Yamatsuji, Kaori Shigemitsu, Hirokazu Uetsuka et al. Retroperitoneal Liposarcoma presenting as Indirect Inguinal Hernia. Acta Med Okayama 2001; 55:51-4.
• 8 Hassan J. M, Quisling SV, Melvin WV, Sharp KW. Liposarcoma of the Spermatic Cord masquerading as an incarcerated Inguinal Hernia. Am J Surg Pathol 2003; 69:163-5.
• 9 Kinne DW, Chu FC, Huvos AG, Yagoda A, Fortner JG: Treatment of primary and recurrent retroperitoneal liposarcoma. Twenty five year experience at Memorial Hospital. Cancer 1973 81, 53-64.
• 10 Weiss SW and Rao VK. Well differentiated liposarcoma (atypical lipoma) of deep soft tissue of the extremities, retroperitoneum and miscellaneous sites. A follow up study of 92 cases with analysis of the incidence of “dedifferentiation”. Am. J Surg. Pathol 1992; 16: 1051-8.