Recurrent paratesticular liposarcoma : a case report

Abstract

Introduction and importance: Paratesticular liposarcoma is a rare condition, with fewer than 200 cases reported worldwide. It is a malignant tumor that originates from fat tissue with high risk of recurrence. Herein, we present a contralateral recurrence of a treated paratesticular liposarcoma. To our best knowledge, in the current literature, there is few cases reported with recurrent paratesticular liposarcoma. Case presentation: We report the case of a 62-year-old who presented with a rapidly growing painless right hemiscrotal swelling. Clinical and radiographic evidence suggested the presence of two paratesticular tumors. The patient underwent a radical orchidectomy with resection of the two tumors through an inguinal approach. The histologic examination revealed a sclerosing, well-differentiated liposarcoma. The decision of the multidisciplinary consultation meeting was not to do adjuvant treatment. A follow up of 12 months showed recurrence of the contralateral scrotum revealed by an FDG-PET/scan. Clinical discussion: Paratesticular liposarcoma, a rare spermatic cord tumor, affects adults aged 50-60, often presenting with scrotal swelling. Diagnosis involves ultrasound, computed tomography and magnetic resonance imaging. Surgical intervention, including radical orchiectomy and adjuvant radiotherapy, is common for management, while the role of chemotherapy is inconclusive. High-grade subtypes carry a higher recurrence risk. Conclusion: Paratesticular liposarcoma, is often misdiagnosed preoperatively. it is typically managed through radical orchidectomy, which includes wide excision and high ligation to ensure free surgical margins and avoid recurrence. The role of adjuvant therapy remains debatable. Despite a generally favorable prognosis, long-term follow-up is crucial because of the elevated risk of recurrence.