Gluteal liposarcoma presenting as sciatic hernia: A case report and review of literature

INTRODUCTION: Lipomatous tumors herniating through the sciatic foramen are extremely rare with less than 6 cases reported in the existing literature. We report a case of gluteal well differentiated liposarcoma that presented as sciatic hernia. PRESENTATION OF CASE: A 66-year-old female presented with persistent pain in the right gluteal region. Physical examination coupled with CT/MRI scans identified a firm mass extending into the right pelvic side via the sciatic foramen. It measured approximately 18.9 cm × 13 cm × 22.8 cm. The tumor was resected via transgluteal approach. Immunohistochemical and microscopic features were consistent with well-differentiated liposarcoma. DISCUSSION: Although sciatic hernias associated with intraabdominal contents have been recorded less than 100 times in the literature, instances where gluteal lipomatous tumors manifest as sciatic hernias are even more rare. In this case the gluteal liposarcoma was successfully identified utilizing CT/MRI scanning followed by a transgluteal excision of the mass. CONCLUSION: While sciatic hernias are rare, lipomatous/liposarcomatous tumors presenting as sciatic hernias are extremely rare. This case report highlights a combination of rare phenomena. The information presented adds to the current evidence that will guide accurate diagnosis and appropriate treatment of future cases.