635 Giant Paratesticular Liposarcoma Imitating a Recurrent Right Inguinoscrotal Hernia

Abstract Case 48-year-old male presented for elective open recurrent right inguinal hernia (RIH) repair due to ongoing inguinoscrotal swelling; and an ultrasound suggestive of a large indirect containing peritoneal fat extending into the scrotum with displacement testis. Previous RIH mesh completed 12mths prior found moderate direct hernia; during post-op phone review (given COVID pandemic) noted he was healing well. No urinary/obstructive or systemic symptoms identified. Other history included alpha thalassemia trait, ex-smoker non-English speaking background (NESB). Intraoperatively there no evidence hernia, intact; however scrotal mass identified as cause. An 18x8cm soft lipomatous surrounded testicle extended up towards cord structures at superficial ring. Given concern malignancy, orchidectomy excision performed. Histology confirmed well differentiated grade 1 liposarcoma. He recovered is undergoing close MRI surveillance - sign recurrence. Discussion Liposarcoma important differential masses can imitate on ultrasound, gold standard investigation. The above case highlights importance physical post-operative examination barriers care pandemic, particularly in those NESB. Informed consent imperative, we could safely proceed appropriate surgery patient had been explicitly consented testicular loss nature operation.