Giant scrotal liposarcoma as a differential diagnosis of an inguinoscrotal mass

We present the case of a 60-year-old male patient with a scrotal mass that had been evolving over the previous 2 years. On physical examination, an irreducible tumor was observed that was heterogeneous in consistency and showed no clear relationship with the inguinal canal. CT scan of the abdomen and scrotum revealed a mass measuring 19 × 18 × 32 cm in the right scrotal sac with fat attenuation, reticulation, nodular foci and a solid caudal component with calcifications, suggestive of liposarcoma. The biopsy study reported: a well-differentiated lipoma-type liposarcoma (MDM2, CDK4 and S100 positivity). The Multidisciplinary Committee decided to proceed with excisional surgery. The pathology study identified a well-differentiated liposarcoma of paratesticular soft tissues, measuring 39 cm in diameter, of the sclerosing type; histological grade 1 (FNCLCC); focal necrosis <10%; maximum mitotic index (2 mitoses/mm²). Currently, the patient is in follow-up with the Oncology Department, receiving no adjuvant treatment. This case shows the importance of making a correct differential diagnosis of inguinoscrotal masses for adequate and rapid management of the patient’s pathology (Fig. 1).

Fig. 1