Abstract Background This case report highlights two unusual surgical phenomena: lipoma-like well-differentiated liposarcomas and sciatic hernias.It illustrates the need to nitrile gloves in a bucket be aware that hernias may not always simply contain intra-abdominal viscera.Case presentation A 36 year old woman presented with an expanding, yet reducible, right gluteal mass, indicative of a sciatic hernia.However, magnetic resonance imaging demonstrated a large intra- and extra-pelvic fatty mass traversing the greater sciatic foramen.The tumour was surgically removed through an abdomino-perineal approach.
Subsequent pathological examination revealed an atypical lipomatous tumour (synonym: lipoma-like well-differentiated liposarcoma).The patient remains free from recurrence two years following her surgery.Conclusion The presence of a gluteal mass should always suggest the possibility of a sciatic hernia.However, in this case, the hernia consisted of an atypical lipoma spanning click here the greater sciatic foramen.Although lipoma-like well-differentiated liposarcomas have only a low potential for recurrence, the variable nature of fatty tumours demands that patients require regular clinical and radiological review.