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Unusual findings in the inguinal canal: a report of four cases
D Poenaru1, D A Jacobs, I Kamal
1Department of Surgery, Kingston General Hospital, Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.
Insights
Masses in the inguinal canal are rare and challenging to diagnose preoperatively. This study highlights uncommon groin masses, including cystic lymphangioma, neuroblastoma metastasis, epidermal inclusion cyst, and ovarian cyst, emphasizing the need for a broad differential diagnosis.
Area of Science:
- Pediatric Surgery
- Surgical Pathology
- Diagnostic Imaging
Background:
- Inguinal canal masses are typically hernias, but other pathologies can occur.
- Preoperative diagnosis of non-hernia inguinal masses requires a high index of suspicion.
- Recognizing uncommon masses is crucial for appropriate surgical planning.
Observation:
- A cystic lymphangioma presented as a soft, partly reducible mass in a 3-month-old boy.
- Neuroblastoma metastasis was diagnosed in an irreducible groin mass in a 15-month-old girl.
- An epidermal inclusion cyst and an incarcerated hemorrhagic ovarian cyst were found in older girls.
Findings:
- The study identified four rare inguinal canal masses: cystic lymphangioma, neuroblastoma metastasis, epidermal inclusion cyst, and ovarian cyst.
- These cases demonstrate the diverse range of non-hernia pathologies that can manifest in the inguinal region.
- Clinical presentation varied, from reducible to irreducible and painful masses.
Implications:
- Awareness of these uncommon entities can improve preoperative diagnosis of inguinal masses.
- This broadens the differential diagnosis beyond typical hernia contents.
- Accurate preoperative identification facilitates timely and appropriate surgical intervention.
Abstract:
Masses in the inguinal canal other than hernias are rare occurrences, and their preoperative diagnosis requires a high index of suspicion. A soft, partly reducible groin mass in a 3-month-old boy proved to be a cystic lymphangioma within the inguinal canal. A 15-month-old female who presented with an irreducible inguinal mass was found to have a neuroblastoma metastasis in the groin. An irreducible groin mass in a 6-year-old female proved to be an inguinal canal epidermal inclusion cyst. A 14-year-old female presented with a painful groin swelling that represented an incarcerated hemorrhagic ovarian cyst. An awareness of the wide spectrum of entities other than the standard bowel, testicle, and ovary in the inguinal canal can help to identify uncommon pathologies preoperatively.