Abstract

Background: The commonest differentials in a case of inguinal swelling are a hernia, hydrocele, lipoma and lymph nodal mass. However, we may come across some rare causes of inguinal lumps such as leiomyosarcoma. This is a case of an elderly gentleman who presented with a history of a painless, progressively enlarging mass over the right inguinal region which on further investigation was found to be a malignant tumour. Case presentation: A 70-year-old male patient presented with a mass over the right inguinal region 7 × 7 × 8 cm in size. It was nonreducible and non-trans illuminant. There was no cough impulse either. Sonography of the lump revealed a heterogeneous mass originating in the right inguinal canal queried to be an enlarged lymph node. Computed tomography (CT) scan of the abdomen and pelvis had similar findings. Fine needle aspiration cytology (FNAC) of the lump was inconclusive. The patient underwent an excision biopsy, and intraoperatively a huge fleshy tumour originating from the spermatic cord structures was visualized. Histopathological examination was suggestive of a grade II leiomyosarcoma. Conclusion: Spermatic cord leiomyosarcoma, although rare, should be kept in mind when dealing with an unusual lump in the cord. This article reviews the literature regarding paratesticular leiomyosarcoma presentation, diagnosis, and treatment.

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