# 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.

## Key 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.