A surprising hitchhiker: incidental spermatic cord liposarcoma discovered during inguinal hernia repair

Abstract

Spermatic cord liposarcomas are rare neoplasms that often present as inguinal hernias, posing diagnostic challenges. We report case of a 51-year-old male who underwent inguinal hernia repair, during which solid mass was incidentally discovered on spermatic cord. Mass was excised and subjected to histopathological analysis. Initial histopathological evaluation suggested a well-differentiated liposarcoma (G1) with involved surgical margins, leading to referral to a multidisciplinary sarcoma team. However, reevaluation at a specialized center indicated findings more consistent with benign adipose tissue, highlighting the diagnostic complexities associated with this rare entity. This case underscores the importance of a thorough diagnostic workup and multidisciplinary follow-up in management of rare neoplasms, ensuring accurate diagnosis and appropriate treatment. It also highlights that surgeons should remain vigilant for unexpected intraoperative findings, recognizing that the initial diagnosis prompting surgery may not encompass all underlying pathologies. Such awareness is crucial for comprehensive patient care and optimal surgical outcomes.