A Rare Case of Sigmoid Colon Carcinoma in Incarcerated Inguinal Hernia

Dario Baldi,Carlo Cavaliere,Gianluca Spidalieri,Osvaldo Micera,Simona Baselice,Vincenzo Alfano,Bruna Punzo,Liberatore Tramontano

doi:10.3390/diagnostics10020099

Abstract

Incarcerated inguinal hernia is a common diagnosis in patients presenting a painful and nonreducible groin mass. Although the diagnosis is usually made by physical examination, the content of the hernia sac and the extent of the surgical operation may vary and can require multimodal imaging integration (e.g., ultrasonography, computed tomography); the usual finding is a segment of small bowel and, less commonly, large bowel. We present an extremely rare case of a sigmoid cancer incarcerated in a left inguinal hernia and infiltrating the spermatic cord. The patient underwent whole-body computed tomography (CT) with contrast agent injection for staging, followed by a left hemicolectomy paralleled by a unilateral orchiectomy.

Highlights

Inguinal hernia is a common problem in adults, with a 4% prevalence for adults >45 years of age [1]
As for inguinal carcinoma, Lejars [4] classified three types of neoplasmes herniaires in 1889. When it integrates the hernial sac for a primitive pathology originating from anatomical structures, it possesses the sac such as the peritoneal serosa and the spermatic cord, such as of saccular tumors; otherwise, the pathology can affect the organ or structures organized in the sac itself, and they are named intrasaccular tumors
We present an 88-year-old man with a left-side sigmoid colon carcinoma in incarcerated inguinal hernia

Summary

Introduction

Inguinal hernia is a common problem in adults, with a 4% prevalence for adults >45 years of age [1]. As for inguinal carcinoma, Lejars [4] classified three types of neoplasmes herniaires in 1889. When it integrates the hernial sac for a primitive pathology originating from anatomical structures, it possesses the sac such as the peritoneal serosa and the spermatic cord, such as of saccular tumors; otherwise, the pathology can affect the organ or structures organized in the sac itself, and they are named intrasaccular tumors. Intrasaccular tumors are primary tumors of abdominal organs (for example, bladder, colon and appendix cancers) contained within the inguinal sac [5]; left colon carcinoma is the most common of these [6]. We present an 88-year-old man with a left-side sigmoid colon carcinoma in incarcerated inguinal hernia.

Case Report

Findings

Discussion