Giant non Hodgkin lymphoma of Scarpa's triangle: a case report

A 72-year-old lady was admitted to hospital with a large, bleeding mass on the right groin and an 8-month history of deep vein thrombosis of the left leg with pulmonary microembolisation treated medically. On clinical examination there was a solid, necrotising and bleeding right inguinal mass which extended 20 cm below the right inguinal ligament. A tissue biopsy, performed under local anaesthesia, revealed the presence of a non Hodgkin lymphoma with giant B-cells of follicular origin. An angio-CT scan of the pelvis and of the leg showed the compression of the 30 cm diameter tumour on the surrounding tissues. The mass appeared to be extra-compartmental and to have a non-homogeneous aspect with internal areas of necrosis and colliquation. Particular attention was devoted to the femoral vessels which were apparently not involved in the tumour mass. The patient was then operated on by a team of vascular and plastic-reconstructive surgeons. She underwent an operation consisting in an inguinal mass excision and skeletisation of the femoral vessels and nerve. The wound was then closed using both an abdominal and lateral flap from the hip. Postoperatively the patient made an uneventful recovery and was discharged from hospital on postoperative day 11. Follow-up at 3 months showed good healing of the wound and no signs of metastatic spread of the tumour.