Primary omental fibromatosis presenting as an incarcerated inguinal hernia: Case report from a single institution over 20 years

Abstract

Inguinal omental fibromatosis is a rare disease entity that could mimic incarcerated inguinal hernia clinically. In the present study, we review the incidence of inguinal omental fibromatosis at our centre. From 1 January1996 to 30 June 2016, all hernia operations performed in all the affiliated hospitals of the University of Hong Kong were reviewed retrospectively; data were retrieved from patient records. A total of 7039 hernia operations were carried out during the period, in which 564 were incarcerated or strangulated hernia operations, and two were omental fibromatosis, accounting for an incidence of 0.028 per cent of groin explorations. In the present study, we report the second case at our centre. A 26‐year‐old man was admitted with a history of reducible right groin mass from birth. The mass had become irreducible for 2 months. The patient had no symptoms of bowel obstruction. On palpation, a firm mass was found in the right groin extending to the right scrotum, and could not be reduced completely. Bilateral testes in the scrotum were palpable. Computed tomography scan of pelvic cavity showed that there was a herniated omentum in the right scrotum. The omental mass was completely resected and free‐tension repair was performed. The histopathological examination revealed that the tumour consisted of spindle‐shaped cells that were consistent with fibromatosis. Inguinal omental fibromatosis is rare and could present as incarcerated hernia clinically. Fibromatosis could be part of a syndromal disease presentation, such as Gardner syndrome. Recurrence is higher than in sporadic cases, despite radical surgery.