Báo cáo y học: Synchronous colonic carcinomas presenting as an inguinoscrotal hernial mass: a case report

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Báo cáo y học: "Synchronous colonic carcinomas presenting as an inguinoscrotal hernial mass: a case report"Journal of Medical Case Reports BioMed Central Open AccessCase reportSynchronous colonic carcinomas presenting as an inguinoscrotalhernial mass: a case reportSiao Pei Tan*, Siong-Seng Liau, Shaymau M Habeeb and Dermot ORiordanAddress: Department of General Surgery, West Suffolk Hospital, Hardwick Lane, Bury St Edmunds, IP33 2QZ Suffolk, UKEmail: Siao Pei Tan* - siaopei@gmail.com; Siong-Seng Liau - liauss@doctors.org.uk; Shaymau M Habeeb - shaymau2001@yahoo.com;Dermot ORiordan - Dermot.ORiordan@wsh.nhs.uk* Corresponding authorPublished: 28 June 2007 Received: 23 February 2007 Accepted: 28 June 2007Journal of Medical Case Reports 2007, 1:36 doi:10.1186/1752-1947-1-36This article is available from: http://www.jmedicalcasereports.com/content/1/1/36© 2007 Tan et al; licensee BioMed Central Ltd.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: A carcinoma within a hernia in the groin is uncommon, with an incidence of less than 0.5 percent of all excised sacs. This article describes a case of synchronous colonic carcinomas, one of which presented as an inguinoscrotal mass. Case presentation: A 69-year old man presented with a large, irreducible left inguinoscrotal hernia and symptoms of obstruction. On examination, there was an 8 cm palpable mass within the hernia sac. CT scan revealed small and proximal large bowel obstruction secondary to a large ingunoscrotal sac and synchronous colonic tumours of the transverse colon and the ascending colon. The former presented as an inguinoscrotal mass. Laparotomy revealed a large tumour mass arising from the transverse colon in the hernia sac. The procedure was followed by an extended right hemicolectomy, during which the second tumour in the ascending colon was also resected. Conclusion: This case demonstrates a rare but interesting occurrence of primary transverse colon carcinoma presenting in a hernia sac, in conjunction with a synchronous tumour of the ascending colon. Prognosis is comparable to patients with a solitary tumour of similar pathological staging when the resection is curative. The presence of an inguinal hernia itself does not signify an increased risk of colorectal malignancy. However, in the presence of obstruction, incarceration, and weight loss, malignancy should be suspected. Thorough clinical examination, flexible sigmoidoscopy or radiographic evaluation is necessary preoperatively in such patients. Surgical resection, with or without adjuvant oncological treatment, should be performed as soon as possible, using established techniques with modifications according to involvement of local structures. occurs when the incarcerated hernia contains an organBackgroundCarcinomas in hernias in the groin are divided into saccu- with a primary carcinoma. The commonest of these caseslar, intrasaccular and extrasaccular [1], based on the ana- is a sigmoid colon carcinoma presenting in the lefttomical relation to the sac. A saccular tumour is when the inguinal hernia [2]. Hernia contents of urological andprimary or metastatic disease directly involves the perito- gynaecological origin are also possible. We report the firstneal sac, (for example a mesothelioma or peritoneal case reported in the literature with one of two synchro-metastases from other organs). Intrasaccular tumour nous primary tumours presenting within a hernia, and to Page 1 of 4 (page number not for cita ...