The Case of Huge Pure Lipoma of the Spermatic Cord Misdiagnosed as Inguinal Hernia

Abstract

Clinically, pure spermatic-cord lipoma has not been recognized as a disease entity but regarded as an incidental finding at the time of hernia repair, because it presents groin symptoms and clinical findings indistinguishable from those of inguinal hernia. We report the successful treatment of case of huge pure spermatic-cord lipoma originally misdiagnosed as inguinal hernia. The patients had tumor excision without orchiectomy. Symptoms improved without any complication. In patients with inguinal hernia symptoms, pure spermatic-cord lipoma should be recognized as a significant clinical entity, and differential diagnosis should be achieved using ultrasonography and computed tomography to avoid unnecessary hernia repair.

Keywords: Diagnosis; Herniorrhaphy; Inguinal hernia; Misdiagnosis; Spermatic cord lipoma.

Figure 1

On scrotal sonography, a homogenous hyperechoic mass was noted, while both testes were intact. Axis, vertical cephalad; *, lipoma.

Figure 2

Preoperative computed tomography revealed a club-shaped, enlarged fatty component of the spermatic cord in the right inguinal canal and right scrotal sac. Yellow arrows, both testes.

Figure 3

The tumor had a size of 10 × 7.5 × 5 cm, ovoid shape, and consisted of a hard and well-encapsulated mass. On cut surface, the mass had yellowish appearance and appeared to have collected fluid.