Giant paratesticular spindle cell lipoma: A rare case report

Introduction: Spindle cell lipoma (SCL) is a rare condition primarily occurring in subcutaneous tissue. Only 4 cases of paratesticular SCL have been reported. Case presentation: A 51-year-old man presented with a painless mass in his left testicle that has grown for nine years. Physical examination revealed a soft, smooth-surfaced left scrotal mass measuring 30 x 30 cm, which did not transilluminate. A contrast-enhanced abdominal-pelvic CT scan showed a paratesticular mass measuring 31.1 x 15.1 x 30.5 cm extending to the spermatic cord. Preoperative tumor markers, including AlphaFetoprotein (AFP), Human Chorionic Gonadotropin (HCG), and Lactate Dehydrogenase (LDH), were within normal ranges. Surgical exploration and excision successfully removed the tumor, measuring 39.0 x 37.0 x 16.0 cm and weighing 10 kg, revealing a spindle cell lipoma on pathology examination. Immunohistochemistry testing for CD34 was positive. Three months post-surgery, the patient was in good health with normal sexual function. Discussion: Paratesticular SCL is a benign neoplasm. Distinguishing spindle cell lipoma from liposarcoma radiologically is challenging. Therefore, a biopsy and histopathological examination are essential. CD34 Immunohistochemistry aids in determining SCL from liposarcoma. Complete excision following thorough preoperative preparation and accurate diagnostic procedures is recommended. Conclusion: Paratesticular SCL cases are rare, with good preoperative preparation and accurate post-operative diagnosis; good results will likely be expected, and this case report will likely contribute to ongoing research to enhance the understanding and management of paratesticular SCL cases.