Giant Paratesticular Liposarcoma: A Case Report and Brief Review of the Literature.

Paratesticular tumors are rare neoplasms, with liposarcomas of the spermatic cord representing an uncommon malignant subtype. These tumors typically grow slowly and may attain a considerable size before diagnosis because of their indolent clinical course. We report the case of a 65-year-old male patient who presented with a progressively enlarging left-sided scrotal swelling of five years' duration. Based on clinical examination and ultrasonographic findings, a left paratesticular neoplasm was suspected. Contrast-enhanced computed tomography revealed a large heterogeneous fat-containing lesion encasing the spermatic cord. The patient underwent complete surgical excision with left radical orchidectomy. Histopathological features (mature adipocytes with fibrous septae and atypical stromal cells), supported by immunohistochemistry (MDM2 intense nuclear positivity), confirmed the diagnosis of well-differentiated liposarcoma. The postoperative course was uneventful, and no adjuvant treatment was administered; he was kept on regular follow-up. He remains free of local recurrence and distant metastasis at 24 months of follow-up. This case highlights the importance of considering paratesticular liposarcoma in the differential diagnosis, particularly in patients presenting with slowly progressive scrotal swellings. Early diagnosis and complete surgical excision with negative margins remain the cornerstone of management and are essential for achieving optimal disease control and favorable long-term outcomes.