Sonographic appearance of a large lipoma of the spermatic cord presenting clinically as an inguinoscrotal hernia

Lipoma of the spermatic cord or the round ligament is called inguinal canal lipoma. It may present as an inguinal herniating mass of fat tissue, with or without an accompanying herniating sac. There are few reports about large lipomas of the spermatic cord. We describe a case of a large spermatic cord pure lipoma, initially suspected to be an inguinal hernia upon physical examination. We diagnosed the lipoma with ultrasound and magnetic resonance imaging. The patient subsequently underwent left orchiectomy.