Paratesticular Liposarcoma Presenting as an Inguinal Swelling: A Diagnostic Conundrum

TL;DR

A rare case of paratesticular liposarcoma was misdiagnosed initially but later confirmed through surgery and histopathology.

Contribution

This case highlights the diagnostic challenges of paratesticular liposarcoma and emphasizes the importance of accurate histopathological analysis.

Findings

The patient's inguinal swelling was initially misdiagnosed as a lymph nodal mass.

Histopathology confirmed a high-grade paratesticular dedifferentiated liposarcoma with rhabdomyoblastic differentiation.

The rarity of the tumor complicates decisions regarding adjuvant therapies like chemotherapy and radiotherapy.

Abstract

Paratesticular tumours are rare malignancies that are frequently misdiagnosed on presentation. We present a case of an elderly male with a six-month history of painless, progressively increasing left inguinal swelling. On preliminary examination and investigation, the swelling was misdiagnosed as a lymph nodal mass. Subsequently, a magnetic resonance imaging study detected a lesion that was not distinct from the spermatic cord. Biopsy testing of the said lesion was suggestive of poorly differentiated spindle cell neoplasm. The patient then underwent a high inguinal orchidectomy. Histopathological examination confirmed the diagnosis of a high-grade paratesticular dedifferentiated liposarcoma with rhabdomyoblastic differentiation. Due to the rarity of such tumours, the need for adjuvant chemotherapy and radiotherapy is debated.

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