The Case of Huge Pure Lipoma of the Spermatic Cord Misdiagnosed as Inguinal Hernia

Abstract

Clinically, pure spermatic-cord lipoma has not been recognized as a disease entity but regarded as an incidental finding at the time of hernia repair, because it presents groin symptoms and clinical findings indistinguishable from those of inguinal hernia. We report the successful treatment of case of huge pure spermatic-cord lipoma originally misdiagnosed as inguinal hernia. The patients had tumor excision without orchiectomy. Symptoms improved without any complication. In patients with inguinal hernia symptoms, pure spermatic-cord lipoma should be recognized as a significant clinical entity, and differential diagnosis should be achieved using ultrasonography and computed tomography to avoid unnecessary hernia repair.

Sonographic appearance of a large lipoma of the spermatic cord presenting clinically as an inguinoscrotal hernia

“…Sonography is sufficient to evaluate a scrotal mass and differentiate a testicular mass from a scrotal lipoma. 11 We found that the mass did not show any connection to the peritoneal cavity and therefore we could exclude an inguinal hernia. However, sonography alone is insufficient to diagnose a giant spermatic cord lipoma.…”

Adrenal ectopy and lipoma of an inguinal hernia sac: A case report & literature review

“…While ultrasonographic evaluation is typically effective at differentiating testicular carcinoma from lipoma, unclear sonographic findings and a high symptomatic suspicion of lipoma (i.e. slowly growing, non-reducible, fixed, relatively hard, nontender mass) should prompt further preoperative modalities of investigation such as CT or MRI for diagnostic confirmation [ 7 ].…”

Poliosis and neurofibromatosis type 1: Is it a true association?

“…Spermatic-cord lipomas are usually detected incidentally during the hernia repair surgery. Therefore, Jo et al advised to perform an abdominopelvic CT and MRI in patients with a slowly growing, non-reducible, fixed, relatively hard and non-tender mass [3]. Moreover, an encysted spermatic cord hydrocele was described in a male patient as a painful, well circumscribed, 4 cm sized swelling in the left inguinal region which clinically mimicked an incarcerated inguinal hernia [4].…”