Peritoneal Serous Papillary Adenocarcinoma found from Tumor within an Inguinal Hernia Sac

Shuzo Kohno, Tadakazu Shimoda*, Toshio Iino, Takashi Nikaido*, Koumei Umeda**, Kenji Sakurai

Department of Surgery I, Department of Pathology*, Jikei Medical University, Ogura Hospital**

A 63-year-old woman was admitted with a painful left groin lump on July 18, 1993. Under a clinical diagnosis of incarcerated left inguinal hernia, herniorrhaphy was performed. The sac was found to contain nests of cells consistent with a metastatic adenoccarcinoma. The patient was readmitted for further work up. Gynecological examination was within normal limits. Computed tomographic (CT) scans of the chest, abdomen, and pelvis were also negative. Gastrointestinal and colon fiberscopy was performed, but was also netative. On September 13, 1993, the patient underwent exploratory laparotomy, following a laparoscopy. Laparotomy revealed multiple and polynesic cicatrices in the omentum. Omentobrusectomy was performed. The pathologist diagnosed the omental and inguinal tumor as a peritoneal serous papillary adenocarcinoma. Tumors within hernial sacs are rare. Peritoneal serous papillary adenocarcinoma is relatively rare, but is occasionally diagnosed due to abdominal tumor or distension. We have described the unusual case of inguinal hernia-sac cancer. To the best of our knowledge, this is the first report of peritoneal serous papillary adenocarcinoma in an inguinal hernial sac.

Key words
peritoneal serous papillary adenocarcinoma, hernia-sac tumor, peritoneoscopy

Reprint requests
Shuzo Kohno Department of Surgery I, Jikei Medical University
3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105 JAPAN

Accepted
October 12, 1994

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