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Primary malignant peritoneal mesothelioma in an incarcerated groin hernia: report of a case
Mario Testini1, Anna Scattone, Beatrice Di Venere
1Department of Applications in Surgery of Innovative Technologies, Section of General Surgery and Vascular Surgery and Clinical Oncology, University of Bari, Cesare 11, 70124, Bari, Italy.
Abstract:
Malignant peritoneal mesothelioma arising from the inguinal hernia sac is rare. We report the case of a 71-year-old man examined in our emergency department for a bilateral inguinoscrotal hernia, which was recurrent in the right groin, and primary and incarcerated in the left groin. An emergency exploratory operation revealed a firm mass, 10 cm in diameter, in the left inguinal hernia sac. The remaining peritoneal surface appeared macroscopically normal. Therefore, we resected the mass and performed a Rutkow hernioplasty. The patient was discharged after a short, uneventful recovery, and was referred to the oncology department for adjuvant therapy. He is now well and asymptomatic with no evidence of ascites, 26 months after his operation. A mesothelioma of the hernial sac peritoneum was the final histological diagnosis.
Insights
Malignant peritoneal mesothelioma rarely arises from inguinal hernia sacs. This case highlights a rare instance of mesothelioma found within an inguinal hernia sac, successfully resected with a positive patient outcome.
Area of Science:
- Oncology
- Surgical Pathology
- Hernia Surgery
Background:
- Malignant peritoneal mesothelioma is a rare cancer.
- Inguinal hernias are common surgical conditions.
- Mesothelioma originating from a hernia sac is exceptionally rare.
Observation:
- A 71-year-old man presented with bilateral inguinoscrotal hernias, incarcerated on the left.
- Exploratory surgery revealed a 10 cm mass within the left inguinal hernia sac.
- The rest of the peritoneum appeared normal.
Findings:
- The mass was surgically resected, and a Rutkow hernioplasty was performed.
- Histological diagnosis confirmed mesothelioma of the hernial sac peritoneum.
- The patient recovered well and remained asymptomatic 26 months post-operation.
Implications:
- This case underscores the importance of thorough pathological examination of hernia sac contents.
- It expands the differential diagnosis for masses found in inguinal hernias.
- Highlights the possibility of rare oncological diagnoses in seemingly routine surgical cases.