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A case report of incarcerated inguinal hernia: Amyand's hernia with adenocarcinoma tumor
Michele Fiordaliso1, Shadi Ahmad1, Sladana Simic1
1Department of Surgery, Erbach General Hospital, Germany.
Introduction:
Inguinal hernia is one of the most common surgical problems, often posing technical challenges even to expert surgeons. Amyand's hernia (AH) is an inguinal hernia whose sac contains the vermiform appendix. Primary appendiceal neoplasms are rare. We report the case of an appendiceal adenocarcinoma within an Amyand's hernia, presenting as an incarcerated right inguinal hernia.
Presentation Of Case:
A 87-year-old male presented in the emergency department due to a persistent right inguinal pain. Clinical examination revealed a tender right groin mass. Under the diagnosis of an right inguinal hernia, an operation was taken. Intraoperatively, an inflamed appendix and a part of the cecum were found in the hernia sac. The operation was completed with an ileocecal resection and a modified Bassini hernia repair. Histological examination revealed a adenocarcinoma of the appendix.
Discussion:
Amyand's hernia is an inguinal hernia that contains vermiform appendix in its sac. It consists 1% of all inguinal hernias while appendicitis in an Amyand's hernia accounts for 0.1% of all appendicitis cases. Adenocarcinomas of the appendix are even rarer, accounting for 0.2% to 0.5% of all intestinal malignancies, and 4%-6% of primary appendiceal neoplasms. Diagnosis is usually established intraoperatively.
Conclusion:
A malignancy of the appendix should always be in the differential diagnosis of a right inguinal mass, in order to provide optimum surgical treatment.
