A Case of Metastatic Colon Cancer in an Inguinal Hernia Sac for which FDG-PET was Useful in Preoperative Diagnosis

Junichi Takamizawa, Shingo Kuze, Takanori Kyokane, Hiroaki Shibahara and Eiji Higaki

Department of Surgery, Fukuroi Municipal Hospital

We report a case of metastatic colon cancer in an inguinal hernia sac diagnosed by FDG-PET and treated surgically. A 74-year-old man undergoing sigmoidectomy for perforated sigmoid colon cancer in January 2006 was found in October 2007 to have serum CA19-9 elevated to 100.9 U/ml. Although neither abdominal US nor CT suggested recurrence, FDG-PET showed high FDG accumulation in the right inguinal area and the right ventral bladder. Reexamination of CT showed enhanced nodules at corresponding sites. Under a diagnosis of metastatic colon cancer in an inguinal hernia sac, we conducted laparotomy, finding hard tumors at the inguinal hernia orifice and in the inguinal hernia sac. Combined with an inguinal approach, we completely resected the inguinal saccular tumors. Resected specimens showed two tumors at the tip and the orifice of the inguinal hernia sac, one 25 mm and the other 20 mm in diameter. Histological examination comfirmed metastatic saccular carcinoma of sigmoid colon cancer previously resected. The postoperative course was good, and the man is doing well without recurrence eight months after surgery.

Key words
inguinal hernia, metastatic saccular tumor, FDG-PET

Reprint requests
Junichi Takamizawa Department of Surgery, Fukuroi Municipal Hospital
2515-1 Kunou, Fukuroi, 437-0061 JAPAN

Accepted
January 28, 2009

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