Inadvertent Inguinal Sarcoma Excision during Hernia Surgery: Outcomes, Gender Analysis, and Prevention

Figure 4

Case example: preoperative imaging comparison of ultrasound and CT scan. The images are of a 72-year-old male who presented with a firm testicular mass with associated scrotal swelling. (a) A scrotal ultrasound shows a mixed echotexture heterogeneous lesion within the left scrotum. Unfortunately, sonographic evaluation of inguinal or scrotal lesions lacks specificity in distinguishing fat- or bowel-containing inguinal hernia from a soft tissue sarcoma, such as a liposarcoma. (b–d) Sagittal, coronal, and axial contrast-enhanced preoperative CT images in the same patient demonstrate a predominately low-attenuation fatty 10 cm mass lesion within the inferior left inguinal canal and left scrotum. The presence of a thickened capsule around the periphery of the lesion as well as prominent enhancing internal septations with nodularity increases suspicion of a well-differentiated liposarcoma.

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