Tardu Ali, Yagci Mehmet Ali, Karagul Servet, Ertugrul Ismail, Kayaalp Cuneyt
Inonu University, Department of Surgery, Malatya, Turkey.
Inonu University, Department of Surgery, Malatya, Turkey.
Int J Surg Case Rep. 2016;20:46-8. doi: 10.1016/j.ijscr.2016.01.005. Epub 2016 Jan 14.
Retroperitoneal masses presenting as an inguinal hernia are rare conditions.
A 53 year old male admitted with the symptoms of weight loss, abdominal discomfort and left sided recurrent inguinal hernia. Physical examination demonstrated an abdominal mass in the left flank and an irreducible, painless scrotal mass. He had a history of left sided inguinal hernia surgery six years ago. Computed tomography revealed a large enhancing left sided retroperitoneal mass invading the colon, pancreas and kidney and it was going down towards the left scrotum. Unblock tumor resection including the neighboring organs (left kidney, left colon, distal pancreas with spleen) was performed. Scrotal extension of the tumor was also excised and the inguinal canal was repaired primarily. Histopathology of the mass was myxoid-liposarcoma. The patient has disease free, without hernia recurrence but poor in renal function after twenty months follow-up.
Large retroperitoneal tumors may grow towards the inguinal region and they can mimic an inguinal hernia. An irreducible, painless and hard scrotal mass should be considered from this perspective.
表现为腹股沟疝的腹膜后肿块是罕见情况。
一名53岁男性因体重减轻、腹部不适和左侧复发性腹股沟疝症状入院。体格检查发现左侧腰部有一腹部肿块以及一个无法回纳、无痛的阴囊肿块。他六年前有左侧腹股沟疝手术史。计算机断层扫描显示左侧有一个巨大的强化腹膜后肿块,侵犯了结肠、胰腺和肾脏,且肿块向下延伸至左侧阴囊。进行了包括邻近器官(左肾、左结肠、带脾脏的胰腺远端)的整块肿瘤切除。肿瘤向阴囊的延伸部分也被切除,腹股沟管进行了一期修复。肿块的组织病理学检查为黏液样脂肪肉瘤。经过20个月的随访,患者无疾病复发,无疝复发,但肾功能较差。
巨大的腹膜后肿瘤可能向腹股沟区生长,且可能类似腹股沟疝。从这个角度来看,应考虑无法回纳、无痛且质地坚硬的阴囊肿块。