Pleomorphic spermatic cord liposarcoma: A case report and review of management

Abstract

Liposarcoma of the spermatic cord is very rare, representing about 7% of para testicular sarcomas. It is considered to be one of the highest malignancy grades. We present a case of a liposarcoma of the spermatic cord in a 45-year-old male complaining of a progressive painless swelling in the right inguinoscrotal region. Ultrasonography and computed tomography findings were compatible with liposarcoma of the spermatic cord. We performed a right radical orchiectomy with a wide resection of the mass. Histological examination confirmed the diagnosis and showed a pleomorphic subtype. The mainstay of management of spermatic cord liposarcoma is wide excision with radical orchiectomy. The most important factors for prognosis are the histologic subtype and surgical margin status. Adjuvant radiotherapy should be considered in cases at high risk for local recurrence. Long-term surveillance is mandatory. Liposarcoma of the spermatic cord is an uncommon para testicular tumor which should be part of the differential diagnosis of inguinoscrotal mass. A radical inguinal orchiectomy with wide resection of the soft tissue mass and the spermatic cord are the key to longest local and systemic disease-free survival.

Keywords: Liposarcoma; Orchiectomy; Para testicular tumor; Spermatic cord.

Fig. 1

Axial CT Image showing a heterogeneously mass in the right hemi-scrotum, containing fat and soft tissue.

Fig. 2

Macroscopic appearance of the surgical specimen showing a solid and nodular mass of the adipose tissue, encapsulated and attached to the spermatic cord.

Fig. 3

Gross examination of the mass revealed a large, encapsulated, yellow-brown colored fatty tissue. The mass weighed 736 gm. Atrophic testis was adherent to the mass.