Arteriovenous malformation of the spermatic cord mimicking reducible inguinal hernia

Arteriovenous malformations are a vascular anomaly most often found in the central nervous system; however, they can present ubiquitously in any organs or tissues. We present the case of a 55-year-old man who developed a tender, reducible inguinal bulge and underwent laparoscopic transabdominal preperitoneal inguinal hernia repair under the clinical diagnosis of an inguinal hernia. Intraoperative observation revealed no hernia sac, but a poorly defined spermatic cord mass, appearing to be responsible for the patient's symptoms, was found and removed. The pathology of the mass was consistent with the diagnosis of an arteriovenous malformation of the spermatic cord. Surgeons should keep in mind the small possibility of arteriovenous malformations in patients with clinical presentation of an inguinal hernia, as they may cause massive bleeding during and after the operation unless handled appropriately.