Lipomas are considered one of the most frequent benign mesenchymal tumors with copious variants. Among these variants is angiomyxolipoma (AML) which is considered an extremely rare entity. To the best of our knowledge, only 19 cases have been reported in the English medical literature, of which three of them involving the spermatic cord. Herein, we report the fourth case of a 37-year-old male patient with angiomyxolipoma (AML) of the spermatic cord discovered incidentally during elective hernia repair.

BACKGROUND: Angiomyxolipoma (AML) is a rare variant of benign lipoma with characteristic histopathological and immuno-histochemical features. It consists of fatty tissue admixed with myxoid stroma and blood vessels. It was first described by Mai et al. in 1996 [1], with a total number of 19 cases reported since.
METHODS: This is the first report of an AML in subcutaneous tissue of the face, presenting as a 4-month old cystic lesion in a 78-year old lady. Diagnosis was based on radiological and histopathological with cytochemical findings.
CONCLUSIONS: It is important to distinguish this lesion as distinct from malignant subcutaneous lesions of fatty tissue, especially with short history as seen in our case.
CONCLUSIONS: Precise diagnosis of angiomyxolipoma is important to avoid unnecessary investigations, stress and misdiagnosis of myxoid liposarcoma.

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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.

Lipoma is the most common neoplasm of mesenchyme, and several subtypes have been described that vary according to their location and the presence of other tissue elements. Angiomyxolipoma is a very rare variant that consists of an admixture of adipose and myxoid elements with numerous vascular structures. It should be differentiated from other subtypes of benign and malignant lipomas. Here the case of a 69-year-old male is described who presented with a solitary asymptomatic mass on the left iliac crest. The histopathologic findings showed alternating nests of myxoid and adipose tissue containing dilated blood vessels, which was consistent with angiomyxolipoma.