Solid and nodular masses localised in the spermatic cord area and in the paratesticular region are infrequent, not well established and the differential histopathological differential diagnosis is occasionally difficult, particularly in borderline situations. This tends to complicate therapeutic decisions, which can go from the specific exeresis of the mass to a radical infundibulum-orchiectomy, all of which require a careful clinical follow up of the process. This is partly due to the complexity of the anatomical area in which we are concerned, and contains different elements such as: the vas deferens with its convoluted portion, epididymis, embryonic vaginal remains, as well as the testicle with its layers and structures. Histogenetically, this region is composed of different types of tissue: epithelium, mesothelium and mesoderm. For that reason, the histopathological patterns of tumours in the area are heterogeneous and have a different biological and clinical behaviour.We present a male, who at 55 years old, diagnosed with a left spermatic cord lipomatosis, removal of the mass and with a histopathology result of atypical lipoma. Six years later, when 61 years of age, he was seen due to a recurrence of a painless left paratesticular mass. A solid tumour was seen in the preoperative ultrasound. This was surgically removed along with the cord and a left orchiectomy. The histopathology examination showed an atypical lipomatous tumour of the spermatic cord.The borderline characteristics of these histopathological types are analysed, and the subsequent need for a controlled follow up, which may lead to a more favourable prognosis, owing to the fact, that in the spermatic cord, recurrence may be diagnosed earlier, the mass is more superficial and more effective surgery can be performed.