Metastatic carcinoma in inguinal hernia sac

A patient with unexplained low back pain, weight loss, and pulmonary infiltrate underwent an inguinal herniorrhapy. Histologic examination of the grossly normal hernia sac revealed metastatic adenocarcinoma. The patient died of cachexia 10 months later. This case observation suggests the necessity of histologic examination of grossly normal hernia sacs.