Abstract

Liposarcoma is one of the most common soft tissue sarcomas. About 20% of liposarcomas originate in the retroperitoneum. It manifests as painless, slowly enlarging soft tissue mass. Inguinal region is one of the uncommon locations for liposarcoma, the tumor arising from the spermatic cord. In this location, liposarcoma needs to be differentiated from other more common pathologies in the canal including hernia. Very rarely retroperitoneal liposarcoma may manifest as inguinal hernia. We describe a case of a 60-year-old man who presented with left inguinoscrotal mass that was demonstrated to be solid enhancing soft tissue attenuation mass with small areas of fat inside on multidetector-row computed tomography (MDCT). Coronal reformatted CT revealed dumbbell shape of the mass with larger retroperitoneal component contiguous with smaller left paratesticular component across a narrow segment in the inguinal canal. Patient was operated and a large retroperitoneal mass was removed. Histopathology of the resected mass revealed a dedifferentiated liposarcoma. Thus, firm, non-tender and large irreducible inguinoscrotal swelling in an adult should be evaluated by CT to rule out a rare inguinal extension of retroperitoneal liposarcoma. MDCT, besides revealing the diagnosis can determine the true intra-abdominal (retroperitoneal) extent of such a dumbbell shaped tumor when only tip of iceberg is visible in the inguinal region.