Liposarcoma of the testis: A case report

Abstract

Liposarcoma of the testis is a rare genitourinary tumor. Liposarcoma commonly arises in the spermatic cord and rarely arises in the testis. We describe the case of a 60-year-old man who presented with complaints of swelling, associated with pain, in the right testicular region for 3 weeks. The scrotal ultrasound showed a heterogenous, hyperechoic lesion measuring 10 × 7 cm on the right. The testicular lesion appeared irregularly marginated with heterogeneous echotexture, with a central hyperechoic area and peripheral hypoechogenicity. Contrast-enhanced computed tomography of the abdomen showed no intra-abdominal mass or lymphadenopathy. Tumor markers including alpha-fetoprotein, human chorionic gonadotropin, and lactate dehydrogenase were normal. A right high inguinal orchiectomy was performed, and the postoperative histopathologic examination showed features of liposarcoma of the testis with components of myxoid liposarcoma and well-differentiated liposarcoma. There was no evidence of recurrence up to 4 years post-surgery. Thus, misdiagnosis is common in liposarcoma testis due to the rarity and vague presentation. Ultrasound and tumor makers are often negative. A high index of suspicion is required in cases of tumor marker-negative testicular masses. The treatment of choice is high inguinal orchiectomy; evidence for the utility of chemotherapy and radiotherapy is limited.