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A 62 year old man with an inguinoscrotal swelling

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Q1: What is the diagnosis?

Paratesticular liposarcoma with an indirect inguinal hernia. The photomicrograph shows areas of inflammatory and sclerosing types of liposarcoma admixed with a lipoma-like pattern. Inset (A) shows a tumour giant cell and inset (B) a classic lipoblast.

Q2: What are the differential diagnoses of an incompletely reducible inguinoscrotal lump?

Differential clinical diagnoses in our case would include the following:

  • Indirect inguinal hernia with an incarcerated omentocele

  • Indirect inguinal hernia with a vaginal hydrocele

  • Indirect inguinal hernia with a testicular tumour

  • Indirect inguinal hernia with a cord lipoma

  • Indirect inguinal hernia with a paratesticular liposarcoma

Q3: Does the patient require any further treatment postoperatively?

The indications for postoperative radiochemotherapy for paratesticular liposarcoma include: high grade of the tumour, resected margins involved by the tumour, and evidence of lymphovascular invasion.1 This case had none of the above, and hence was not a candidate for adjuvant therapy.

Discussion

Malignant paratesticular tumours are rare. Most paratesticular tumours are benign. Paratesticular …

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