Sclerosing liposarcoma of epididymis: Role of chemical shift magnetic resonance imaging

Abstract

Sclerosing liposarcoma of epididymis is a rare extratesticular scrotal tumor with variable prognosis. Ultrasonography is the initial imaging modality of choice for the evaluation of scrotal mass and helps to differentiate testicular and extratesticular masses, thereby narrowing down the differential diagnosis. Magnetic resonance imaging with its excellent soft tissue resolution can help in the further characterization of the nature of the tumor. In this case report, we highlight the role of chemical shift imaging in making a confident preoperative diagnosis of liposarcoma thereby guiding optimal and timely management.

Keywords: Chemical shift imaging; epididymis; liposarcoma; magnetic resonance imaging; sclerosing.

Figure 1 (A-D)

(A) Grey scale ultrasound shows hyperechoic mass (arrow) separate from the testis (asterisk). (B) Color Doppler ultrasound shows minimal internal vascularity. (C) Axial and (D) coronal contrast-enhanced CT shows heterogeneously enhancing extratesticular mass (arrow) separate from the testes (asterisk). P: Penis

Figure 2 (A-C)

(A) Axial T2-weighted MRI shows heterogeneous hyperintense mass (arrow) in the left hemiscrotum separate from the testis (asterisk). (B) Axial T1-weighted MRI shows heterogeneous isointense mass (arrow) in the left hemiscrotum separate from the testis (asterisk). (C) Sagittal T2-weighted MRI shows clearly the posteroinferior location of the mass (arrow) in relation to the left testis (asterisk) suggesting possible epididymal origin

Figure 3 (A-D)

(A) In-phase and (B) Out-of-phase images from chemical shift MRI shows signal drop within the mass (arrow). (C) Coronal T2-weighted MRI shows heterogeneous hyperintense mass (arrow) in the left hemiscrotum separate from the testis (asterisk). (D) Postcontrast T1-weighted MRI shows heterogeneously enhancing mass (arrow) in the left hemiscrotum separate from the testis (asterisk)