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Intrasaccular caecal adenocarcinoma presenting as enlarging right inguinoscrotal hernia
Max Marsden1, Nathan Curtis1, Shaun McGee2
1Department of Colorectal Surgery, Salisbury District Hospital, Odstock Road, Salisbury, Wilts SP2 8BJ, UK.
Introduction:
Colorectal cancer and inguinal hernias are both common surgical pathologies in the elderly but rarely co-exist. Where the conditions overlap, there can be difficulties in both diagnosis and treatment.
Presentation Of Case:
A 78 year old man with unexplained iron deficiency anaemia was investigated for gastrointestinal cancer. He was found to have enlarging bilateral inguinoscrotal hernias. CT colonoscopy revealed a herniated caecal carcinoma contained within the scrotum. An open excision was performed.
Discussion:
Iron deficiency anaemia without obvious bleeding is associated with colorectal cancer and should be thoroughly investigated. Asymptomatic inguinal hernias are often ignored by patients. However, a change in an existing hernia may be associated with neoplasia.
Conclusion:
Dual pathology raises new difficulties in assessment, investigation and management of colorectal cancer.
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