Cook's Hernia: Renal Tumor Parasitic Vessels Herniating into Right Inguinal Canal

Abstract

We report the incidental findings and management of a hernia whose contents included renal tumor parasitic vessels in a 52-year-old male who presented with a 22 cm large right renal tumor. His initial complaints were right sided fullness and hematuria. Incidentally on CT scan, the patient's large right renal mass was identified, as well as lower pole parasitic tumor vessels which were herniating into the patient's right inguinal canal. Parasitic tumor vessels are often found on larger obscure tumors. Few side effects or associated problems have been reported from issues with the parasitic vessels other than excessive bleeding. Never before, to our knowledge, has an inguinal hernia with renal mass parasitic vessels herniating into it been documented. We named the hernia after the general surgeon, Dr. Craig Cook, MD, FACS, who assisted during the open radical nephrectomy and who reduced and repaired the right inguinal hernia. We present a case presentation and treatment rationale for this tumor and associated parasitic vessels herniation, along with a brief re view of existing literature.