A 71-year-old male was referred to our hospital with right scrotal swelling. The ultrasonography and magnetic resonance imaging revealed a 6.5 cm mass adjacent to the right testicle. Under the preoperative diagnosis of benign intrascrotal lipoma, local tumor excision through scrotal skin incision was performed. The histopathological examination revealed atypical lipomatous tumor/well-differentiated liposarcoma. With the evidence of malignancy, two-stage surgery was mandatory. Thus, radical orchiectomy with high cord ligation and wide excision of surrounding soft tissue structures through inguinal skin incision was performed. However, there were no tumor cells remaining in the resected samples. Neither adjuvant radiation therapy nor chemotherapy has been performed since contrast computed tomography showed no evidence of metastasis. He is free of disease at 1 year postoperatively.
Keywords: atypical lipomatous tumor/well-differentiated liposarcoma; intrascrotal paratesticular tumor; two-stage surgery.