High Grade Sarcoma Right Inguinal Region

33-year-old male with presented for a gradually enlarging right inguinal mass. An infiltrative heterogeneous centrally necrotic and hemorrhagic mass is seen in the right inguinal region. The mass extends both superior and inferior to the inguinal ligament. The femoral neurovascular bundle is encased by the lesion with diffusion restriction and enhancing tumor thrombus identified in the right femoral vein. Numerous additional components of the lesion demonstrate diffusion restriction compatible with viable tumor. There is scattered hemosiderin deposition within the mass. The lesion is heterogeneously enhancing with a component which extends more superiorly into the retroperitoneal space. High-grade soft tissue sarcoma was favored preoperatively. Sarcomas within the in the inguinal regions tend to be difficult to treat due to their large size the time of discovery. Location of the lesion adjacent to critical soft tissue structures such as the femoral neurovascular bundle make complete surgical resection with the goal of limb salvage therapy difficult. Lesions with high-grade, neurovascular invasion, and positive microscopic margins are assisted with poor outcomes.