Liposarcoma of the spermatic cord masquerading as an inguinal hernia.

[well-differentiated liposarcoma]

This is a case of a 70 -year -old male who presented with a mass in his right testicle . He was treated with antibiotics for epididymitis while undergoing serial ultrasounds for one year due to testicular swelling and pain . His fourth ultrasound revealed a mild hydrocele with a large paratesticular mass of undescribed size , superior to the right testicle , thought to be an inguinal hernia . Preoperative CT scan demonstrated a large fat-containing inguinal hernia extending into the scrotal sac . An inguinal hernia repair was complicated by fatty tissue surrounding the testicle requiring a right orchiectomy . Pathology review of the tissue demonstrated well-differentiated liposarcoma with a small focus of dedifferentiation grade 2 tumor . Tumor was identified at the inked margins indicating an incomplete resection . It was decided that no further surgical intervention was needed and the patient would undergo surveillance for local tumor recurrence . Six -month follow-up MRI scan was negative for any recurrence of disease . A liposarcoma presenting as a paratesticular mass with spermatic cord involvement is rare , and imaging studies may fail to distinguish a liposarcoma from normal adipose tissue .