PMC7283968_01
(A) Non-contrast computed tomography suggested an inguinal herniation. (B) Laparoscopic image of swollen retroperitoneal soft tissues.
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At the first consultation, an adipose tissue like a greater omentum entered in a right inguinal area in non-contrast CT before surgery (Fig. 1A). A hernia sac, however, was not found and swollen retroperitoneal fatty tissue near the right internal inguinal ring was observed by laparoscopy (Fig. 1B).
(A) Contrast-enhanced magnetic resonance imaging, showing partial solid components with low in T1 emphasized. (B) High in T2 emphasized. (C) Fatty components with high both in T1 and in T2 emphasized, however low in fat suppression images. (D) Sagittal image in T2. (E) Coronal image in T2 STIR. (F) Contrast-enhanced computed tomography revealed a tumor, including fatty tissue, measuring 80 x 60 mm in front of the major psoas muscle in the hypogastric region.
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Findings of contrast-enhanced CT and MRI revealed an extraperitoneal and lipomatous tumor measuring 80 x 60 mm, extending through the inguinal canal to the scrotum (Fig. 2).
Resected tumor measuring 280 x 200 x 180 mm.
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The resected tumor measured 28 x 20 x 18 cm and weighed 510 g (Fig. 3).
(A) Hematoxylin-eosin staining (200x magnification). (B) mouse double minute 2 immunostaining (100x magnification). (C) Cyclin-dependent kinase-4 immunostaining (100x magnification). (D) p16 immunostaining (100x magnification).
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Positive immunostaining for mouse double minute 2, cyclin dependent kinase-4, and p16 confirmed histopathological diagnosis of a well-differentiated retroperitoneal liposarcoma (Fig. 4).