Transabdominal wall lipoma

Description

A 60-year-old man presented with a painful, enlarged palpable mass in the left iliac fossa. A CT scan of the abdomen and pelvis demonstrated a large heterogeneous mass extending through the abdominal wall musculature (figure 1), which was suspected to be an atypical lipomatous tumour (ALT) or well-differentiated liposarcoma (WD-LPS).

Figure 1

Lipoma passing through the abdominal wall musculature.

Intraoperatively, a large firm lipomatous mass was noted in close proximity to the left spermatic cord. It extended into the retroperitoneal space and transgressed the internal oblique to lie deep to the external oblique aponeurosis, adopting an unusual 'dumbbell' shape. Due to clinical uncertainty as to whether the mass was simply in close proximity to the spermatic cord or a cord liposarcoma, a left radical orchidectomy was performed en bloc with the tumour.

Lipomas are the most common soft tissue mesenchymal tumour,1 and are...

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