INTRODUCTION PLS are rare neoplasms which compose approximately 12% of all liposarcomas; and mostly originate in spermatic cord 1followed by testicular tunics and epididymis. No more than 2200 cases of PLS have been reported till date. Giant PLS is 3-7more rare with only a few case reports. Due to the rarity of the disease, there is no standardized guideline as regards its 8incidence, diagnosis, recurrence and treatment. We present a case of a giant well differentiated PLS measuring 26x24x12 cm. CASE STUDY A 70-year-old man, presented with a painless and slow-growing mass in the right scrotum without conspicuous promoting or alleviating factors. There were no other signs or symptoms. A rm non-tender mass present in the right scrotum, of size 26cm X 24cm X 12cm, was the only positive nding on physical examination. There were no specic abnormalities in the laboratory and imaging Figure 1: Clinical Photograph reports (hemogram, urinalysis, stool routine, ESR, β-human chorionic gonadotropin, a-fetoprotein, liver and kidney function tests and chest X-ray). A provisional diagnosis of testicular malignancy was made. The patient underwent a radical resection of Figure 2: Excised Specimen the tumor with a right orchiectomy. On gross pathological examination, the tumor was 26X24X12cm in size. Figure 3: Microscopic Pathology The cut surface showed grey yellow homogenous areas alternating with brous bands. Microscopy revealed mature bro-adipose tissue alternating with brous areas comprising of collagen bres admixed with spindle cells. Some of them were lobulated and had hyperchromatic pleomorphic nuclei GIANT PARATESTICULAR LIPOSARCOMA: A RARE ENTITY Original Research Paper Manish Verma* Associate Professor, Department Of Surgery, PGIMS, Rohtak, Haryana, India. *Corresponding Author X 27GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS Surgery Paratesticular liposarcoma (PLS) are rare malignant neoplasms; which are derived from mesodermal tissues. They are slow growing tumors and tumors of size greater than 10cm are quite rare. There is no standardized guideline for management. A case of a giant well differentiated PLS measuring 26x24x12cm was encountered and is being described. ABSTRACT KEYWORDS : Paratesticular Tumor, Liposarcoma, Scrotal Mass. Naman Purohit Junior Resident, Department Of Surgery, PGIMS, Rohtak, Haryana, India. M G Vashist Senior Professor, Department Of Surgery, PGIMS, Rohtak, Haryana, India. Sudhir Kumar Senior Resident, Department Of Surgery, PGIMS, Rohtak, Haryana, India. Abhijit Singha Senior Resident, Department Of Surgery, PGIMS, Rohtak, Haryana, India. VOLUME-8, ISSUE-11, NOVEMBER-2019 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra 28 X GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS with incompicous nucleoli (i.e. atypical stromal cells). Lipoblasts and atypical mitotic gures were not conspicous. The right testis and spermatic cord were normal and free from tumor. A diagnosis of atypical lipomatous tumor, sclerosing sub type (well differentiated Liposarcoma) was conrmed. DISCUSSION 9Liposarcoma was rst reported in 1845 by Lesauvage. It 10accounts for 5-7% of paratesticular sarcoma. Liposarcoma are malignant tumors of soft tissue origin and frequently 11involve the adult patients aged 50 to 60 years. Usual sites of involvement are the lower extremities and retroperitoneum in 12about 70% of cases. Paratesticular involvement by 2liposarcoma has been reported in just 200 cases till date. Also, there are only few case reports of size more than 10cm and none more than 20cm. We encountered a giant liposarcoma of size 24X20X14cm. Liposarcoma presents as a painless, slow-growing mass and 2,9may be clinically misdiagnosed as testicular malignancy. Although, Ultrasonography, Computerized Tomography and Magnetic Resonance Imaging are advised for diagnosis of 13paratesticular liposarcoma; MRI is the golden standard. Diagnosis of PLS mainly depends on histopathology, immunohistochemistry and cytomorphological features. Three histological types of liposarcoma have been described, which include well differentiated (WDLPS), myxoid/round cell 13type and pleomorphic type. Myxoid variety is the most 14common type and account for about 50% of all liposarcoma. The histological subtypes of WDLPS are adipocytic, sclerosing, inammatory and spindle cell type. The sclerosing type is more commonly seen in retroperitoneum and spermatic cord. Microscopy of sclerosing type of WDLPS reveals brocollagenous tissue with a brillary appearance. Scattered amongst it are mature adipocytes and bizarre hyperchromatic stromal cells, with few lipoblasts. IHC analysis of liposarcomas shows S100 positivity, while CD 34, 15actin, keratin, desmin all show negativity. In our case, the histopathological features were diagnostic and in favour of WDLPS - sclerosing subtype. Due to paucity of data in literature, on patients with paratesticular liposarcoma, there are no standardized 2guidelines for the management. Multimodality therapy has 16been suggested in literature. There is a general consensus that radical orchiectomy with wide local excision and high ligation of the spermatic cord is the current standard treatment strategy due to frequent recurrence that associated 9,13,17with incomplete excision. 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