Liposarcoma of Spermatic Cord - A Rare Entity

Liposarcoma of the spermatic cord is a rare entity with only two series and less than 100 cases reported in literature. We report a case of a giant liposarcoma of the spermatic cord. A 65-year old man presented with a 2-year history of a progressive painless swelling in the right lower quadrant of the abdomen. He gave a past history of right inguinal hernia repair and excision of a mass lesion of the spermatic cord 15 years back (? nature; no HPE report available). Local examination revealed a large smooth solid mass about 20 × 12 cm in the right iliac fossa and pelvis, firm, non-tender and mobile from side to side. Testes were normal. USG revealed a non-homogenous and hyper echoic. CECT showed a 21 × 11.2 cm well defined mass lesion with mixed densities (18 HU) and minimal enhancement with contrast present in the right iliac fossa and pelvic region. On exploration, a lipomatous mass was found arising from the inguinal portion of spermatic cord. Radical orchiectomy with wide local excision was carried out. Histopathological examination of the resected specimen showed a well differentiated liposarcoma of the spermatic cord (myxoid variant). Margins were negative. Patient was advised long-term follow up in view of high recurrence rate. Liposarcoma of the spermatic cord is rare. Surgical treatment is the management of choice with Radical orchiectomy and wide local excision. Adjuvant radiation should be given if margin status is in doubt. High incidence of local recurrence mandates a long period of follow up.