Abstract
This report involves a rare case of a 74-year-old man who presented with a progressively increasing swelling in the right groin, which represented a squamous cell bladder carcinoma herniating into the right inguinal canal. The manuscript discusses the role of multimodality imaging in bladder carcinoma presenting as an inguinoscrotal hernia. The patient subsequently underwent treatment with a chemotherapy regimen consisting of 5-fluorouracil and mitomycin, which was extrapolated from squamous cell carcinoma of the anal canal, and responded well.
Highlights
Urinary bladder hernia is uncommon, comprising less than 4% cases of all inguinal hernias.[1]
The urinary bladder may herniate into the inguinal canal, scrotum or femoral canal; isolated cases of urinary bladder herniation into the obturator foramen, ischiorectal fossa, as well as through the abdominal/pelvic wall have been reported
Risk is increased with advanced age, usually occurring after the fifth decade of life, probably related to decreased tone of the bladder wall; it tends to occur in obese men.[2]
Summary
Urinary bladder hernia is uncommon, comprising less than 4% cases of all inguinal hernias.[1]. A 74-year-old male, non-smoker with a past medical history of hypertension, benign prostate hypertrophy (BPH) and remote post-traumatic exploratory laparotomy presented to the emergency department with progressively increasing right groin pain and swelling. These symptoms had been present for 2 years, relieved by analgesic use, but had been exacerbated over the last 2 months. Computed tomography (CT) scan of the abdomen and pelvis demonstrated a 6.5 cm × 5.4 cm × 6.4 cm enhancing soft tissue mass in the right inguinal canal, inseparable from the anterolateral aspect of the urinary bladder with an accompanying hydrocoele (Figure 1). Iliac and left para-aortic group of lymph nodes seen on diagnostic CT demonstrated increased tracer activity. The patient received radiation therapy and a chemotherapy regimen consisting of 5-fluorouricil and mitomycin
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