術前画像診断の有用であった精索脂肪肉腫

Abstract

A case of spermatic cord liposarcoma was revealed by imaging diagnosis. The patient was a 59-year-old male, who consulted our clinic with the complaint of painless right scrotal swelling on June 30, 1989. One year earlier, he noticed this swelling, which was slow growing little by little. Palpation revealed a movable mass in right scrotum, 7 x 3 x 3 cm in size and separated from the right testis. Scintigraphy could not show RI accumulation and ultrasonography showed a capsulated homogeneous mass. Computed tomography (CT) and magnetic resonance imaging (MRI) showed capsulated fat-like almost homogeneous mass, which enclosed the right spermatic cord. This mass was suspected of spermatic cord lipoma or liposarcoma and was removed with radical orchiectomy. The weight of the mass was 246 g. This mass had a bunch of grape appearance and consisted of several masses of various sizes surrounding the spermatic cord, and could be separated from the right epididymis and testis. Histological examination revealed well differentiated liposarcoma and lipoma. Spermatic cord liposarcoma is very rare and this preoperative diagnosis is very difficult. Imaging diagnosis, such as CT, MRI may help our preoperative diagnosis.