Case Report: Diagnosis and Treatment of a Giant Retroperitoneal Liposarcoma Presenting as an Irreducible Inguinal Hernia

Abstract Background: Retroperitoneal liposarcoma protrude to the inguinoscrotal area presenting as an irreducible inguinal hernia is extremely rare. For the rare cases and little experience of diagnosis and treatment of this disorder, the clinical guidelines are vacant. We report a successful example for the management of a giant retroperitoneal liposarcoma extending to the inguinoscrotal area. Case presentation: A 55-year-old male patient was admitted to our hospital in August 2018 with a large left inguinal mass without abdominal pain or digestive symptoms. Preoperative contrast-enhanced computed tomography revealed an abdominopelvic huge mass, and ultrasound guided biopsies showed liposarcoma. The patient also suffered from dilated cardiomyopathy and the left ventricular ejection fraction is only 39%. The left renal pedicle was squeezed by the mass and the left glomerular filtration rate is as low as 29.25ml/min. Intraoperatively, the mass was incarcerated in the inguinal canal and involved the left testis. We performed a radical tumor resection with two incisions, including resection of the retroperitoneal tumor, resection of the scrotal tumor and a tension-free repair of left inguinal hernia. The resected specimen for the retroperitoneal part measured 50*28*9 cm, weighed 13.5 kilograms and the scrotal part measured 16.5*7*4.5 cm, weighed 6.2 kilograms. Pathologically, the tumor was diagnosed as a well-differentiated liposarcoma, and originated from perirenal fat. The patient did not undergo adjuvant therapy post-operation and is completely clinical remission fifteen months after the operation. Conclusions: Careful distinction for inguinoscrotal mass is essential to minimize complications and improve patient prognosis. The prime principle to treat well differential retroperitoneal liposarcomas is radical resection with protection of vital organs and vessels.