Spermatic cord liposarcoma: a diagnostic challenge

Abstract

Spermatic cord liposarcoma (SCL) is a rare medical condition; to our knowledge there have been fewer than 100 cases reported in the literature worldwide. As a group, para-testicular tumors are relatively uncommon, and they must be differentiated from tumors of testicular origin with extension to the spermatic cord and its elements. SCL should be suspected in patients experiencing recurrent hernias of the inguinal region. Herein we present two cases of SCL recently diagnosed at our hospital. In both instances, the preoperative diagnosis was inguinal hernia.

Current management of liposarcoma of the spermatic cord: A case report and review of the literature

“…High-grade subtypes (round-cell and pleomorphic) are rarer, but they are associated with a higher rate of recurrence and hematogenous metastasis to the lungs and bone (1,3,8,9). Neither low-nor high-grade liposarcomas typically spread via lymphatic routes, which is consistent with the lack of a survival benefit from superficial inguinal or retroperitoneal lymphadenectomy (1,2,4,8). Local recurrence rates for sarcomas, including liposarcomas of the spermatic cord, have been reported to be as high as 50%.…”

“…Liposarcomas, derived embryologically from mesodermal tissue, are the most common type of sarcoma and account for 3-7% of all spermatic cord tumors (1)(2)(3). Liposarcomas are most commonly located in the lower extremities (41%), retroperitoneum (19%) and inguinal region (12%) (4). Even within the inguinal region, liposarcomas of the spermatic cord are quite rare, with case reports constituting the majority of the published literature on this topic (5).…”

“…Based on the case reports since then, it appears that the majority of the patients with liposarcomas of the spermatic cord present in the fifth or sixth decade of life with a painless, irregular, slow-growing inguinal or inguinoscrotal mass clearly distinct from the testis (3,6,7). As previously mentioned, diagnosing liposarcomas of the spermatic cord preoperatively may be challenging, as this clinical presentation may indicate several more common conditions, including inguinal hernia, lipoma, hydrocele, epididymal cyst, funicular cyst or testicular tumors (3)(4)(5)8,9).…”

Liposarcoma of the spermatic cord: A case report and review of the literature

“…The majority (80%) are benign, with lipoma being the most common [1]. Sarcomas comprise 90% of malignant PTT [2] but account for only 0.01-0.02% of all malignancies [3].…”

Diagnosis and management of spermatic cord tumors

“…These tumors usually affect older patients with the highest incidence between the age of 70 and 79 [7]. However, although this is true considering leiomyosarcoma, fibrosarcoma, and liposarcoma, rhabdomyosarcoma usually appear in young people and is affected by adverse prognosis [7].…”