Inguinal Herniation of the Bladder Mimicking Malignancy in FDG PET/CT: Original Image

Incidental Detection of Inguinoscrotal Bladder Hernia with Associated Factors on ¹⁸F-fluorodeoxyglucose PET/CT Scans

“…2,13 Furthermore, Komorowski et al reported 2 cases of IBH among 464 cases of inguinal hernias (0.43%); whereas, three hernia sac containing the bladder were reported in 54 patients with inguinal hernias (5.5%) in a study by Patle et al 14,15 On review of the literature, approximately 8-10 case reports of IBH, which were incidentally detected on PET/CT imaging, could be identified. 7,[9][10][11][16][17][18][19] Previous studies reported that FDG uptake in the herniated bladder is an important pitfall that may be misinterpreted as tumor metastases. The possibility of misinterpreting the increased focal intense FDG activity in the inguinal canal can be prevented by means of having simultaneous coregistered CT images.…”

“…5,7,10 Multiple factors such as obesity, BPH, increasing intra-abdominal pressure, abdominal wall weakness or defect, decreased bladder tone, or bladder outlet obstruction play a role in ISBH etiopathogenesis. 5,11,13 The impact of major risk factors on ISBH development has not been evaluated in previous studies. To the authors' knowledge, this is the first retrospective study that examines the risk factors associated with the development of ISBH using current PET/CT imaging.…”

“…So, simultaneous interpretation of the PET images with the combined CT data is of utmost importance for differential diagnosis of tumors, preventing misinterpretation as metastasis, and to avoid bladder injury during herniorrhaphy. 7,[9][10][11] Since ISBH is a potential but uncommon cause of incarceration and obstructive bladder dysfunction, an information on risk factors related to body fat composition and the volume of prostatic tissue are needed. Furthermore, there is no clinical study investigating the diagnostic utility of 18 F-FDG PET/CT in detecting ISBH and the impacts of the volumes of prostatic tissue, subcutaneous and visceral fat on the development of an inguinoscrotal hernia (ISH).…”