Dedifferentiated Liposarcoma of the Spermatic Cord: A Case Report

Dedifferentiated liposarcoma of the spermatic cord is an exceptionally rare and aggressive malignancy. Its non-specific clinical presentation and anatomical rarity lead to significant diagnostic and management challenges, with a notable absence of standardized treatment guidelines. Methodology: This report details the case of a 55-year-old male who presented with a painless left groin swelling. Following initial clinical and imaging assessments, a radical orchidectomy with en bloc tumour excision was performed. Histopathological and immunohistochemical analyses of the resected specimen were crucial for definitive diagnosis. Key Findings: A 2.5 x 2.5 x 2.2 cm lesion was identified within the spermatic cord. Microscopic examination revealed an infiltrative neoplasm characterized by hypercellular spindle cells within a myxoid background, alongside atypical mitotic figures. Immunohistochemistry showed strong vimentin and S100 positivity, supporting a diagnosis of sarcoma with DDLPS as a strong possibility. The tumour was unifocal with clear surgical margins. Implications: This case highlights diagnostic pitfalls of spermatic cord DDLPS, often mimicking benign conditions. It underscores the necessity for high clinical suspicion and meticulous histopathological assessment for accurate diagnosis. Radical surgical resection at the earliest with clear margins remains the primary treatment. This report contributes to limited literature, advocating for multi-institutional collaboration and research to establish standardized diagnostic and treatment protocols for this challenging malignancy. Key words: Dedifferentiated Liposarcoma, Spermatic Cord, Case Report, Sarcoma, Radical Orchidectomy, Immunohistochemistry, MDM2, Paratesticular Tumour