Giant primary scrotal lipoma in a low-resource setting: challenges with diagnosis and review of literature.

Anwar Sadat Seidu,Papa Kwesi Fiifi-Yankson,Kwadwo Adae-Aboagye,Ernest Adjei,Joseph Akpaloo,Patrick Danso,Joseph Yorke,Denis Afful-Yorke,Seidu Suhewie Sukenibe,George Amoah,Francis Akwaw Yamoah,Samuel Gyasi Brenu,Samuel Nana Prempeh Agyeman-Gyebi

doi:10.1093/jscr/rjab398

Abstract

Lipoma is the commonest benign mesenchymal tumor composed of matured adipocytes. A literature search revealed few reported cases of giant scrotal lipoma. This article aims to report a giant scrotal lipoma weighing 1100 g and illustrate our challenges with the diagnostic process in a low-resource setting. A 28-year-old male presented with a huge right scrotal mass. Examination revealed the mass had no cough impulse. It was firm, non-tender and lobulated, with definite edges. Scrotal sonography was suspicious of lipoma. Intraoperatively, there was an encapsulated scrotal wall mass and an incidental inguinoscrotal hernia, content being the omentum. The scrotal mass was excised, hernia sac was ligated, and excised and the posterior wall was repaired. Histology confirmed the scrotal mass as a lipoma. Primary scrotal lipomas are rare but should be considered in the differential diagnosis of unusual scrotal masses. Ultrasonography is a useful diagnostic tool in resource-limited settings.

Highlights

Lipoma is the commonest benign mesenchymal tumor composed of matured fat cells [1, 2]
Scrotal ultrasonography (USG) reported a large extra-testicular homogenous echotexture of fat lobules arising from the scrotal wall suggestive of a lipoma
Uncommon scrotal masses are difficult to diagnose by clinical evaluation alone [6]

Summary

INTRODUCTION

Lipoma is the commonest benign mesenchymal tumor composed of matured fat cells [1, 2]. A literature search revealed few reported cases of giant scrotal lipoma weighing 480–700 g [9, 10, 12]. Scrotal ultrasonography (USG) reported a large extra-testicular homogenous echotexture of fat lobules arising from the scrotal wall suggestive of a lipoma. Histology of the excised mass was reported as weighed 1100 g and measured 21 × 7 × 9 cm It appeared yellowish in color and had a fibrous capsule.

DISCUSSION

CONCLUSION