Lipomas of the cord and round ligament occur with a significant incidence. They are common and generally associated with an indirect hernia sac, but not always, as the lipoma may be the only pathology identified during groin exploration. They can cause hernia-type symptoms in the absence of a true hernia (associated with a peritoneal defect). They should be considered in the patient with groin pain and normal examination results. Missed lipoma of the spermatic cord is unfortunately not infrequent and may lead to persistence of post-operative groin pain, with confirmation of unresected cord lipoma on postoperative ultrasound, often necessitating reoperation.
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