Korean J Radiol.  2013 Apr;14(2):218-221. 10.3348/kjr.2013.14.2.218.

Imaging Findings of Angiomyxolipoma of the Spermatic Cord Mimicking Inguinal Hernia

• Cho HS
• Woo JY
• Hong HS
• Yang I
• Lee Y
• Jung AY
• Yang DH
• Kim JW
• Kim JW

• KMID: 1482780
• DOI: http://doi.org/10.3348/kjr.2013.14.2.218

Abstract

We report the case in a 72-year-old man who presented with a right inguinal mass and with a one month history that was initially interpreted as an inguinal hernia. Ultrasonography (US) and computed tomography (CT) demonstrated a right inguinal mass, including myxoid and fat component, extending from the right spermatic cord to the right inguinal subcutaneous layer. Mass excision was performed, and the diagnosis turned out to be angiomyxolipoma. Angiomyxolipoma is a rare tumor and the preoperative diagnosis of this disease is very difficult. However, angiomyxolipoma of the spermatic cord should be considered in the differential diagnosis in patients with an irreducible inguinal mass. Imaging diagnosis, such as US and CT may help to make a preoperative diagnosis.

Keyword

Angiomyxolipoma; Spermatic cord; Inguinal hernia; CT; US

MeSH Terms

Aged
Angiolipoma/pathology/*radiography/*ultrasonography
Hernia, Inguinal/ultrasonography
Humans
Male
Myxoma/pathology/*radiography/*ultrasonography
Spermatic Cord/*pathology/radiography/ultrasonography
*Tomography, X-Ray Computed
*Ultrasonography, Doppler

Figure

• 

  Fig. 1 Angiomyxolipoma of the spermatic cord in 72-year-old man. A. Longitudinal ultrasonography image reveals mixed echogenic mass in right inguinal region. Note separation between hyperechoic area (fat component) and mixed echoic area (myxoid component) by spermatic cord (stars). Mass is outlined by arrowheads. B. Contrast enhanced coronal CT image demonstrates well-defined elongated, homogeneously low attenuated mass (arrows) in right inguinal area. C. Contrast enhanced axial CT image reveals non-enhancing mass (density of lesion [region of interest] was 16 Hounsfield unit) with focal fat density area (open arrows) on anterior peripheral portion of mass. D. Contrast enhanced coronal CT image showing central linear tubular structure (arrows) within mass, indicating spermatic cord. E. In microscope, bland spindle cells and mature adipocytes are dispersed in myxoid stroma. Increased thick- and thin-walled vessels are identified (H & E, × 100). F. In immunohistochemistry, spindle cells are positive for CD34, and negative for desmin, S-100 protein and smooth muscle actin (SMA). CD34 and SMA are positive for vascular endothelial cells and perivascular smooth muscle fibers, respectively (× 400).

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