Liposarcoma of the spermatic cord mimicking a recurrent inguinoscrotal hernia

Abstract

Introduction: The presence of an inguinoscrotal mass can raise doubts between inguinal hernias and paratesticular tumors. The majority of these tumors are benign, commonly lipomas. In terms of malignancy, liposarcomas are the most frequent and are usually well differenciated even though they possess both invasion and local recurrence capability. Rabdomiosarcomas are especially aggressive and tend to metastatize. Case report: We report a case of a 76-year-old patient operated of an inguinal hernia performing a Lichtenstein-type hernioplasty. Three months later he presented a slow growth inguinoscrotal mass clinically compatible with a recurrence of the groin hernia. Intraoperatively a fatty and heterogeneous tumor that infiltrated the spermatic cord, making us suspect malignant tumor. Tumorectomy, orchiectomy and local lymphadenectomy was made. The confirmation of the diagnosis of liposarcoma was based on inmunohistochemistry. The postoperative follow-up studies have not shown evidence of tumor recurrence. Discussion: Liposarcomas of the spermatic cord could probably be underdiagnosed and undertreated because they can mimic benign neoplasm like lipomas or groin hernias.