Chan Kimberley, Odubanjo Tokunboh, Swamy Rajiv, Hosny Mohannad
Urology, East and North Hertfordshire National Health Service (NHS) Trust, Stevenage, GBR.
Pathology, East and North Hertfordshire National Health Service (NHS) Trust, Stevenage, GBR.
Cureus. 2022 Sep 6;14(9):e28856. doi: 10.7759/cureus.28856. eCollection 2022 Sep.
Giant paratesticular liposarcoma (PLS) is an uncommon tumour, often misdiagnosed pre-operatively, which presents as a painless scrotal mass. Early detection and prompt surgical management provide the best outcome. We present an 87-year-old patient with gradually enlarging, painless left scrotal swelling. Ultrasound on initial presentation suggested a benign hernia, resulting in an 11-month treatment delay. Computed tomography (CT) thereafter showed paratesticular scrotal mass measuring 14 x 8 x 7cm. Radical inguinal orchidectomy with high ligation of the spermatic cord was performed. Histopathology and cytogenetics confirmed PLS with both de-differentiated and well-differentiated features involving the spermatic cord margin. The patient had rapid progression to fatal lung metastasis within three months of surgery. Our case highlights that any suspicious fat swelling should be investigated thoroughly and excised promptly if paratesticular liposarcoma is suspected, as delayed management gives poor outcomes.
巨大睾丸旁脂肪肉瘤（PLS）是一种罕见的肿瘤，术前常被误诊，表现为无痛性阴囊肿块。早期发现并及时进行手术治疗可取得最佳疗效。我们报告一例87岁患者，其左侧阴囊逐渐肿大且无痛。初诊时超声提示为良性疝，导致治疗延迟11个月。此后计算机断层扫描（CT）显示睾丸旁阴囊肿块大小为14×8×7cm。行根治性腹股沟睾丸切除术并高位结扎精索。组织病理学和细胞遗传学检查证实为PLS，具有去分化和高分化特征，累及精索切缘。患者术后三个月内迅速进展为致命性肺转移。我们的病例强调，如果怀疑为睾丸旁脂肪肉瘤，任何可疑的脂肪肿胀都应进行彻底检查并及时切除，因为延迟治疗效果不佳。
