National Institute of Health Research, Imperial College London.

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We present the case of a 60-year-old man who was referred with a 1-year history of a slow-growing right scrotal lump. Following surgical excision together with a radical orchidectomy, the histological diagnosis was of a paratesticular dedifferentiated liposarcoma. Radiological staging showed no metastatic disease. Six months later the patient presented with a new left scrotal lump, which was felt to be separate from the testis. Owing to the previous history of a liposarcoma and indeterminate ultrasound findings, this was surgically excised without orchidectomy. Histological analysis showed this to be an angiolipoma. The patient remained on clinical and radiological surveillance. Paratesticular tumours are rare neoplasms and liposarcomas of the spermatic cord only represent 7% of these lesions. Any link between lipomatous tumours and liposarcomas remains controversial and is still under investigation. This is the first case to report a paratesticular liposarcoma and a contralateral angiolipoma in the same patient.