Journal of Case Reports and Images in Urology 4, 2019. J Case Rep Images Urol 2019;4:100009Z15AZ2019. www.edoriumjournals.com/ej/crj/jcriu Zarami et al. 1 CASE REPORT OPEN ACCESS Giant scrotal lipoma: Case report and review of literature Abba Bukar Zarami, H. Ibrahim, A. G. Ibrahim ABSTRACT Introduction: Lipoma is a benign mesenchymal neoplasm, the primary scrotal type is extremely rare and most of them develop from the content rather than the wall of the scrotum and they are often confused with liposarcomas clinically. In the few reported cases the largest primary scrotal lipoma to date measured 13.5x10x5 cm. Cytogenetically, 80% of solitary lipomas exhibit chromosomal aberrations, such as rearrangements of 12q13–15, 6p21–22, or deletions of 13q12–14 and 13q22 with 1% tendency of malignant transformation. Case Report: A 42-year-old nomadic Fulani who presented with extremely rare giant primary scrotal lipoma that measured 60x40x12 cm and weighed 38.4 kg. To our knowledge this is the largest scrotal lipoma reported in the literature. Conclusion: Scrotal lipoma can be colossal and leads to diagnostic challenges, especially in developing countries. Total surgical removal of the involved scrotal mass or a compartmental resection has been suggested as treatment of choice; however, the infiltrating type has high chances of local recurrence despite surgical excision. Nevertheless, the tumor rarely transforms into malignancy. Abba Bukar Zarami 1 , H. Ibrahim 2 , A. G. Ibrahim 2 Affiliations: 1 Department of Histopathology, University of Maiduguri/ University of Maiduguri Teaching Hospital, Mai- duguri, Borno State Nigeria; 2 Department of Surgery, Uni- versity of Maiduguri/ University of Maiduguri Teaching Hos- pital, Maiduguri, Borno State Nigeria. Corresponding Author: Dr. Abba Bukar Zarami, Department of Histopathology, University of Maiduguri/ University of Mai- duguri Teaching Hospital, Maiduguri, Borno State Nigeria; Email: abbabukarami51@yahoo.com Received: 17 March 2019 Accepted: 02 April 2019 Published: 07 May 2019 Keywords: Giant, Diagnostic challenges, Lipoma, Scrotum How to cite this article Zarami AB, Ibrahim H, Ibrahim AG. Giant scrotal lipoma: Case report and review of literature. J Case Rep Images Urol 2018;3:100009Z15AZ2019. Article ID: 100009Z15AZ2019 ********* doi: 10.5348/100009Z15AZ2019CR INTRODUCTION Lipomas are the most common benign mesenchymal tumors worldwide and have an estimated incidence of 10% and prevalence of 2.1 per 1,000 [1, 2]. They are commonly present in subdermal and mostly subcutaneous locations that point in the differential diagnosis with liposarcomas, which are almost always deep-seated and it can occur in any region of the body [3–5]. The majority of the tumor occurs in the upper half of the body, particularly the trunk and neck, but they can also develop on the hands and feet [6]. Lipoma of the scrotum are extremely rare [7] and most of them originate and develop in the spermatic cord. In rare cases, scrotal lipoma can originate outside the spermatic cord or in the subcutaneous fat [8]. The location of the lesion form the basis for the classification of the tumor into intramuscular (most common in the trunk) and intermuscular (most common in the anterior abdominal wall including the scrotum) [9]. The second classification are paratesticular and extratesticular lipomas. Most patients develop the tumor in their fifth or sixth decade of life and it rarely affects children [10]. We present extremely rare and giant scrotal lipoma that may cause diagnostic challenges especially in underprivileged health facility centres. CASE REPORT PEER REVIEWED | OPEN ACCESS