case_images: PMC7306526_01
case_images: A: CT axial image illustrating a right inguinal canal soft tissue density measuring 4.87 x 4.03 cm. B: CT coronal image with right inguinal soft tissue density measuring 5.14 cm in length. C: CT axial image 22 months prior illustrating prominent fat in the right inguinal canal region surrounding the cord structures with no suspicious lesions.
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case_images: A computerized tomography (CT) scan revealed a right inguinal canal soft tissue mass measuring 5.1 x 4.87 x 4.03 cm that was not present on previous imaging 22 months prior for an episode of nephrolithiasis (Fig. 1).
case_images: A: Right inguinal surgical approach with the spermatic cord lesion and right testicle in vivo. B: Gross image of the right inguinal mass excision with radical orchiectomy. The testicle is on the left and liposarcoma is on the right. C: Intraoperative image of the right inguinal mass excision with radical orchiectomy with the liposarcoma bisected illustrating the bulky heterogeneous solid lesion and typical yellow-tan appearance measuring 9 x 6 x 5 cm.
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case_images: There was high concern for malignancy prompting an en bloc resection of the mass with a radical orchiectomy to ensure negative margins (Fig. 2).
case_images: A: Hematoxylin and Eosin stained sections of the mass (200X) illustrating the well-differentiated component at the bottom, consisting of mature variably sized adipocytes with bands of fibrous stroma which contain occasional enlarged hyperchromatic nuclei. The dedifferentiated component is seen above, consisting of a cellular spindle cell proliferation. B: Hematoxylin and Eosin stained sections of the mass (400X) demonstrating the the nonlipogenic sarcoma aspect of the specimen, which is composed of closely packed high-grade plump fibroblast-like cells arranged in a fascicular pattern. Mitoses are easily identified.
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case_images: Histopathological tissue analysis revealed a grade 2 dedifferentiated liposarcoma measuring 9 x 6 x 5 cm and weighed 100 g (Fig. 3).