Large dermoid cyst of the spermatic cord presenting as an incarcerated hernia: a rare presentation and literature review

Abstract

Dermoid cyst of the spermatic cord is a very rare clinical entity with only a few cases reported in the literature so far. We herein describe an extremely rare case of a large dermoid cyst of the spermatic cord measuring 8.5 x 5 x 5 cm in a young patient who presented with clinical manifestations of an incarcerated inguinal hernia. After the cyst excision, a diffuse direct hernia became apparent and a Lichtenstein polypropylene mesh repair was performed. Direct hernia was likely the result of chronic pressure on the inguinal floor maintained by the large cyst. We conclude that although very rare, dermoid cyst of the spermatic cord should be considered as a part of the differential diagnosis in patients presenting with an irreducible inguinal mass of a long course.

Dermoid cyst of the spermatic cord in children

“…Unlike the dermoid cyst, the epidermoid cyst does not contain skin appendages in its wall. That they do not contain structures foreign to the skin, as cartilage, bone, respiratory, or gastrointestinal cells separate them from the cystic benign teratomas that are found in ovary, testicle, retroperitoneal, and sacrococcygeal regions [1,3,5].…”

“…Dermoid cyst of the round ligament and the spermatic cord are exceptional [7]. A review of the literature reveals 9 clear cases of dermoid cyst of the spermatic cord, all of them in adults [1,[3][4][5].…”

“…We present a case of dermoid cyst of the spermatic cord in a 2-year-old boy, the youngest patient reported so far. Dermoid cysts of the spermatic cord should be considered as part of the differential diagnosis of inguinal masses in children, especially in cases of long-standing, nontender, and irreducible inguinal mass.Most of masses located in the inguinal region in children correspond to inguinal indirect hernias, although other pathologic entities may be found, such as other types of hernias, inguinal cord cysts, undescended testis, adenopathies, varicoceles, hematomas, femoral artery aneurysms, varix or thrombophlebitis of the saphena vein, lipomas, lymphangiomas, angiomas of the round ligament, supernumerary pectineus bursa, pedunculated uterine fibroids, neuroblastoma metastasis, and epidermoid and dermoid cysts [1][2][3][4]. Here, we present a case of dermoid cyst of the spermatic cord in a 2-year-old boy.…”

Inguinal Lymphatic Malformation: A Rare Case Report

“…Although hernia is the most common abnormality of the inguinal region², other pathological entities may also be found [4][5][6] . They are subdivided into macrocystic, microcystic and combined varieties.…”

Undescended Testis Presenting as Incarcerated Inguinal Hernia in Adults: A Rare Case and Literature Review

“…Inguinal hernia accounts for 75% of abdominal wall hernias and is the most common abnormality of the inguinal area [1,2]. Incarcerated inguinal hernia, a common surgical indication in the emergency room, occurs when the intra-abdominal contents become trapped in the narrow space at the external or internal ring, preventing reduction.…”