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A 62 year old man with an inguinoscrotal swelling

Q1: What is the diagnosis?
Paratesticular liposarcoma with an indirect inguinal hernia. The photomicrograph shows areas of inflammatory and sclerosing types of liposarcoma admixed with a lipoma-like pattern. Inset (A) shows a tumour giant cell and inset (B) a classic lipoblast.

Q2: What are the differential diagnoses of an incompletely reducible inguinoscrotal lump?
Differential clinical diagnoses in our case would include the following:

• Indirect inguinal hernia with an incarcerated omentocele
  
• Indirect inguinal hernia with a vaginal hydrocele
  
• Indirect inguinal hernia with a testicular tumour
  
• Indirect inguinal hernia with a cord lipoma
  
• Indirect inguinal hernia with a paratesticular liposarcoma
  

Q3: Does the patient require any further treatment postoperatively?
The indications for postoperative radiochemotherapy for paratesticular liposarcoma include: high grade of the tumour, resected margins involved by the tumour, and evidence of lymphovascular invasion.¹ This case had none of the above, and hence was not a candidate for adjuvant therapy.

Discussion
Malignant paratesticular tumours are rare. Most paratesticular tumours are benign. Paratesticular neoplasms can arise from the epididymis, spermatic cord, or mesenchymal layers surrounding the testis. Liposarcomas represent about . . . [Full text of this article]

Relevant Article

A 62 year old man with an inguinoscrotal swelling

A Basu, S Ranjith, S Jagdish, S C Sistla, and S Jayanthi
Postgrad. Med. J. 2006 82: e16. [Extract] [Full Text] [PDF]