SJLA_2024_A15: Inguinal Lymphangioma in an Adult Patient Mimicking an Irreducible Inguinal Hernia

Abstract

Background: Lymphangiomas are rare benign vascular malformations of the lymphatic system. It is usually located in the head, neck, and axilla and is typically present during the first 2 years of life. A few cases of inguinal lymphangioma have been reported in adults. Methods: Case report. Discussion: Lymphangioma rarely occurs in the inguinal region, presenting a diagnostic challenge as it mimics various inguinal conditions. Differential diagnoses include inguinal hernia, hydrocele of the cord, lymphadenopathy, or hematoma. Imaging is used to determine the size, invasion, relation to surrounding structures, and extension to the abdominal cavity. Magnetic resonance imaging is the diagnostic modality of choice in nonemergency settings. Complete surgical excision is the gold standard for the management with the lowest risk of recurrence. Alternative non-surgical treatment options have been used successfully in poor surgical candidates. Different sclerosing agents have been used with low complications and rates of recurrence. Ethanol is a widely available sclerosing agent, and it was used with no recurrence or side effects during the follow-up period. Conclusion: Surgeons should have a high index of suspicion when investigating any inguinal mass, considering such a rare presentation as part of the differential. Sclerotherapy is an effective treatment for lymphangioma and should be considered as an alternative modality in nonsurgical candidates.