Spermatic cord lipoma
Inguinal canal lipomas, also known as spermatic cord or round ligament lipomas, are a relatively common but often under-recognized finding on imaging.
Clinical presentation
Lipomas are usually asymptomatic but can sometimes cause pain and discomfort. They can present as a mass lesion.
Pathology
They have no communication with the peritoneal fat. They are not considered as true tumors of fat but as extrusions of extraperitoneal fat extending into the inguinal canal.
Radiographic features
Ultrasound
It is seen as a well defined, solid hyperechoic mass lesion, expanding the inguinal canal and gently effaces the spermatic cord.
CT
The lesion shows attenuation corresponding to fat (-20 to -70 HU). No associated soft tissue component or enhancement.
MRI
Oval shaped lesion with typical fat signal characteristics:
- T1: high signal
- T2: high signal
- fat-suppressed sequences: shows fat suppression
Treatment and prognosis
They are a benign entity and no treatment is usually required in incidental asymptomatic cases. Resection can be offered to patients who are clinically symptomatic.
Differential diagnosis
On imaging, possible differential considerations include:
- inguinal hernias containing fat
- other inguinal canal / spermatic cord masses
- subcutaneous lipoma overlying the spermatic cord
See also
Siehe auch:
Assoziationen und Differentialdiagnosen zu Lipom des Leistenkanals:
