Varga-Szabó D, Papadakis M, Pröpper S, Zirngibl H
Chirurgisches Zentrum, Helios Klinikum Wuppertal, Wuppertal, Germany.
Chirurgisches Zentrum, Helios Klinikum Wuppertal, Wuppertal, Germany.
Int J Surg Case Rep. 2016;19:134-6. doi: 10.1016/j.ijscr.2015.12.022. Epub 2015 Dec 18.
Umbilical hernia is a common finding in many cases, posing potentially life-threatening complications, such as incarceration or strangulation. The presence of malignancy in hernia sacs is, however, rather rare.
Here we report on a case of primary peritoneal adenocarcinoma found through histological examination of omental tissue, resected due to an incarcerated umbilical hernia of an 84-years-old woman. There was no macroscopic sign of malignancy during operation; only after routine examination of histological sections the diagnosis was found.
To our knowledge this is the first report of primary peritoneal cancer as content of an umbilical hernia. This is a rare neoplasm and histologically identical to epithelial ovarian carcinoma. For this reason, the diagnosis is usually based on the histological finding and exclusion of a primary ovarian tumor. Primary peritoneal cancer has a poor outcome in general. Early diagnosis is, therefore, essential for effective treatment.
Histological analysis of resected hernia sac or content should be performed routinely to discover malignant diseases in the background of a hernia.
脐疝在许多病例中很常见，可能会引发危及生命的并发症，如嵌顿或绞窄。然而，疝囊中出现恶性肿瘤的情况相当罕见。
在此，我们报告一例通过大网膜组织的组织学检查发现的原发性腹膜腺癌病例，该病例来自一名84岁女性，因脐疝嵌顿而接受手术切除。手术过程中未发现恶性肿瘤的宏观迹象；仅在对组织切片进行常规检查后才做出诊断。
据我们所知，这是首例将原发性腹膜癌作为脐疝内容物的报告。这是一种罕见的肿瘤，在组织学上与上皮性卵巢癌相同。因此，诊断通常基于组织学发现并排除原发性卵巢肿瘤。原发性腹膜癌总体预后较差。因此，早期诊断对于有效治疗至关重要。
应常规对切除的疝囊或内容物进行组织学分析，以发现疝背景下的恶性疾病。
