Abstract：
UNASSIGNED: The literature regarding size descriptions for spermatic cord lipomas is limited. The term \"giant\" is utilized loosely and seen on case reports for masses as small as 6 cm. Here we present a case of a giant left sided spermatic cord lipoma, found incidentally during a recurrent inguinal hernia repair, that measured 18 × 14 × 10 cm on final pathologic examination.
METHODS: A 59 year old male, with a history of morbid obesity and surgical history of prior bilateral inguinal hernia repair, presented with recurrent left sided groin and scrotal bulging with associated discomfort several months after the initial hernia repair. Following imaging performed on preoperative work up, the patient was brought to the operating room for a robotic inguinal hernia repair.
UNASSIGNED: Preoperative physical examination was limited due to the patient\'s body habitus which precluded a definitive diagnosis of inguinal hernia based on physical examination. Computed tomography of the abdomen and pelvis was performed with findings consistent with bilateral recurrent inguinal hernias. A bilateral robotic inguinal hernia repair was attempted. The procedure was converted to open via a groin incision when an incidental 18 cm left sided spermatic cord lipoma was discovered. An orchiectomy was ultimately performed as the mass was intimately intertwined with the spermatic cord.
CONCLUSIONS: In our case, the patient had a recurrent inguinal hernia and an incidental finding of an 18 cm spermatic cord lipoma which warranted a left orchiectomy followed by open inguinal hernia repair. We propose standardizing the term \"giant\" to include spermatic cord lipomas >15 cm.
METHODS: A 59 year old male, with a history of morbid obesity and surgical history of prior bilateral inguinal hernia repair, presented with recurrent left sided groin and scrotal bulging with associated discomfort several months after the initial hernia repair. Following imaging performed on preoperative work up, the patient was brought to the operating room for a robotic inguinal hernia repair.
UNASSIGNED: Preoperative physical examination was limited due to the patient\'s body habitus which precluded a definitive diagnosis of inguinal hernia based on physical examination. Computed tomography of the abdomen and pelvis was performed with findings consistent with bilateral recurrent inguinal hernias. A bilateral robotic inguinal hernia repair was attempted. The procedure was converted to open via a groin incision when an incidental 18 cm left sided spermatic cord lipoma was discovered. An orchiectomy was ultimately performed as the mass was intimately intertwined with the spermatic cord.
CONCLUSIONS: In our case, the patient had a recurrent inguinal hernia and an incidental finding of an 18 cm spermatic cord lipoma which warranted a left orchiectomy followed by open inguinal hernia repair. We propose standardizing the term \"giant\" to include spermatic cord lipomas >15 cm.
摘要：
未经证实：关于精索脂肪瘤大小描述的文献有限。术语“巨大”被松散地使用，并在病例报告中看到小至6厘米的肿块。这里我们介绍了一个巨大的左侧精索脂肪瘤，在复发性腹股沟疝修补术中偶然发现，最终病理检查测量18×14×10厘米。
方法：59岁男性，有病态肥胖史和既往双侧腹股沟疝修补术史，首次疝气修补后数月，出现复发性左侧腹股沟和阴囊膨出并伴有不适。在术前工作中进行成像后，患者被带到手术室进行机器人腹股沟疝修补术。
UNASSIGNED：由于患者的身体习性，术前体格检查受到限制，无法根据体格检查明确诊断腹股沟疝。对腹部和骨盆进行了计算机断层扫描，发现与双侧复发性腹股沟疝一致。尝试了双侧机器人腹股沟疝修补术。当发现偶然的18厘米左侧精索脂肪瘤时，通过腹股沟切口将该程序转换为开放。由于肿块与精索紧密交织在一起，因此最终进行了睾丸切除术。
结论：在我们的案例中，患者腹股沟疝复发,偶然发现18cm精索脂肪瘤,需要进行左侧睾丸切除术,然后进行开放式腹股沟疝修补术.我们建议将术语“巨大”标准化，以包括>15厘米的精索脂肪瘤。
方法：59岁男性，有病态肥胖史和既往双侧腹股沟疝修补术史，首次疝气修补后数月，出现复发性左侧腹股沟和阴囊膨出并伴有不适。在术前工作中进行成像后，患者被带到手术室进行机器人腹股沟疝修补术。
UNASSIGNED：由于患者的身体习性，术前体格检查受到限制，无法根据体格检查明确诊断腹股沟疝。对腹部和骨盆进行了计算机断层扫描，发现与双侧复发性腹股沟疝一致。尝试了双侧机器人腹股沟疝修补术。当发现偶然的18厘米左侧精索脂肪瘤时，通过腹股沟切口将该程序转换为开放。由于肿块与精索紧密交织在一起，因此最终进行了睾丸切除术。
结论：在我们的案例中，患者腹股沟疝复发,偶然发现18cm精索脂肪瘤,需要进行左侧睾丸切除术,然后进行开放式腹股沟疝修补术.我们建议将术语“巨大”标准化，以包括>15厘米的精索脂肪瘤。
