Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2019 Jan-Mar;23(1):e2018.00064.
doi: 10.4293/JSLS.2018.00064.

Retroperitoneal Liposarcoma: A Concern in Inguinal Hernia Repair

M Lechner  1 , K Borhanian  1 , S Mitterwallner  1 , R Bittner  1 , E Klieser  2 , G Köhler  1 , K Emmanuel  1 , F Mayer  1
Affiliations
Case Reports

Retroperitoneal Liposarcoma: A Concern in Inguinal Hernia Repair

M Lechner et al. JSLS. 2019 Jan-Mar.

Abstract

Background and objectives: The goal of the study was to evaluate retroperitoneal sarcomas with continuous growth into the scrotum through the inguinal canal with regard to diagnostic approach, surgical treatment, and outcome. The analysis is based on a comprehensively documented case and a complete systematic review of published literature. Potential pitfalls are highlighted.

Methods: We describe the case of a 57-year-old male Caucasian who presented with a swelling in the right groin. Suspecting a scrotal hernia, transabdominal preperitoneal plasty surgery was planned but intraoperatively a large retroperitoneal mass was revealed. After computed tomography scan and magnetic resonance imaging, a complete resection of the tumor was performed. Ten previously published cases describing the same pathology were retrieved from the PubMed database and analyzed systematically in a complete literature review.

Results: Histology showed a well-differentiated liposarcoma with tumor-free resection margins. Twenty-two months postoperatively, the patient is in complete clinical remission.

Conclusion: Preoperative clinical suspicion of retroperitoneal involvement is paramount for developing of a surgical strategy and in unclear cases demands extended preoperative diagnostic workup. Following the appropriate patient management is crucial to prognosis.

Keywords: Hernia; Inguinal; Retroperitoneum; Sarcoma; Transabdominal preperitoneal plasty.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors declare no conflict of interest regarding the publication of this article.

Figures

Figure 1.
Figure 1.
Intraoperative laparoscopic view of retroperitoneal tumor, tumor margins outlined by arrows.
Figure 2.
Figure 2.
Preoperative computed tomography scan showing retroperitoneal and scrotal mass (arrows).
Figure 3.
Figure 3.
Preoperative magnetic resonance imaging scan showing retroperitoneal and scrotal mass (arrows).
Figure 4.
Figure 4.
Specimen with retroperitoneal and scrotal part after resection (arrows show narrowing of tumor in the inguinal canal).
Figure 5.
Figure 5.
Microscopic view (magnification 400x): most adipocytes have one vacuole and an eccentric nucleolus (shown by green arrow). However, some appear multivacuolated and small with a concentric nucleolus (shown by red arrow).
See this image and copyright information in PMC

References

    1. Mettlin C, Priore R, Rao U, Gamble D, Lane W, Murphy P. Results of the national soft-tissue sarcoma registry. J Surg Oncol. 1982;19(4):224–227. - PubMed
    1. Fletcher CD. The evolving classification of soft tissue tumours—An update based on the new 2013 WHO classification. Histophathology. 2014;64(1):2–11. - PubMed
    1. Milic DJ, Rajkovic MM, Pejcic VD. Primary omental liposarcoma presenting as an incarcerated inguinal hernia. Hernia. 2005;9(1):88–89. - PubMed
    1. Trans-Atlantic RPS Working Group. Management of primary retroperitoneal sarcoma (RPS) in the adult: A consensus approach from the Trans-Atlantic RPS Working Group. Ann Surg Oncol. 2015;22(1):256–263. - PubMed
    1. Longbotham JH, Joyce RP. Retroperitoneal liposarcoma presenting as spermatic cord tumor. Urology. 1987;30(3):276–280. - PubMed

Supplementary concepts

LinkOut - more resources