Murata Anna, Yoshida Rika, Kato Shota, Nagai Hideyuki, Maruyama Minako, Yoshizako Takeshi, Ishikawa Masako, Nagase Mamiko, Kaji Yasushi
Shimane University, Faculty of Medicine, Department of Radiology, Izumo, Shimane Prefecture, Japan.
Shimane University, Faculty of Medicine, Department of Obstetrics and Gynecology, Izumo, Shimane Prefecture, Japan.
Radiol Case Rep. 2024 Nov 28;20(2):1069-1074. doi: 10.1016/j.radcr.2024.10.140. eCollection 2025 Feb.
Fallopian tube carcinoma, presenting as an inguinal hernia, is a rare entity. We report the case of a woman in her 70s with a history of hysterectomy and right oophorectomy 29 years prior who presented with left cervical lymphadenopathy and elevated CA125 levels. Imaging revealed a tubular structure in the left pelvic region extending into the inguinal hernia sac. Contrast-enhanced computed tomography revealed a tubular structure with solid components in the left pelvic region that herniated through the left inguinal canal. Magnetic resonance imaging further characterized the solid component within the tubular structure and revealed features suggestive of malignancy. Fluorodeoxyglucose positron emission tomography/computed tomography revealed fluorodeoxyglucose uptake in the solid component and multiple enlarged lymph nodes, indicating lymph node metastasis. Subsequent laparoscopic resection confirmed high-grade serous carcinoma originating from the fallopian tube. Fallopian tube carcinoma typically presents nonspecific symptoms but elevated CA125 levels. Imaging often shows sausage-shaped masses. The mechanism in this case involved increased mobility of the left adnexa after hysterectomy and tumor infiltration near the inguinal canal. This case highlights the importance of considering fallopian tube carcinoma as a differential diagnosis when evaluating inguinal hernias, particularly in high-risk patients.
表现为腹股沟疝的输卵管癌是一种罕见的疾病。我们报告了一例70多岁的女性病例，该患者29年前有子宫切除术和右侧卵巢切除术史，此次因左侧颈部淋巴结肿大和CA125水平升高就诊。影像学检查显示左侧盆腔区域有一管状结构延伸至腹股沟疝囊内。增强计算机断层扫描显示左侧盆腔区域有一带有实性成分的管状结构，该结构通过左侧腹股沟管突出。磁共振成像进一步对管状结构内的实性成分进行了特征描述，并显示出提示恶性肿瘤的特征。氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描显示实性成分及多个肿大淋巴结有氟脱氧葡萄糖摄取，提示有淋巴结转移。随后的腹腔镜切除术证实为起源于输卵管的高级别浆液性癌。输卵管癌通常表现为非特异性症状，但CA125水平升高。影像学检查常显示腊肠样肿块。本例的机制是子宫切除术后左侧附件活动度增加以及肿瘤浸润至腹股沟管附近。该病例强调了在评估腹股沟疝时，尤其是在高危患者中，将输卵管癌作为鉴别诊断的重要性。
