Primary Malignant Peritoneal Mesothelioma in an Incarcerated Groin Hernia: Report of a Case

Testini, Mario; Scattone, Anna; Venere, Beatrice Di; Lissidini, Germana; Piccinni, Giuseppe; Palmisano, Silvia; Serio, Gabriella

doi:10.1007/s00595-004-2920-4

Cited by 15 publications

(9 citation statements)

References 11 publications

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“…DPMM clinically presenting as a hernia is extremely rare, there are only a few case reports written worldwide. Approximately 7% of patients with DPMM may develop hernias, most often inguinal or umbilical as a result of the increased abdominal pressure caused by ascitic fluid 5 7. The hydrocele in our patient was initially suspect for tunica vaginalis involvement, but additional examinations disproved this hypothesis and showed tumour localisation in the right inguinal region with hydrocele that was best explained as a result of the ascites.…”

Section: Discussionmentioning

confidence: 52%

Unusual presentation of a late-onset recurrence of malignant peritoneal mesothelioma

et al. 2017

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A man aged 79 years with a history of malignant peritoneal mesothelioma presented 8 years after primary presentation with a suspected right-sided painful inguinal hernia and hydrocele, both present for 5 months. During surgery, however, the inguinal swelling appeared to be a tumour. Laboratory examination was non-alarming and ultrasonography not specific for mesothelioma. Pathological examination showed it to be a recurrence of the malignant mesothelioma, which was treated palliative with radiotherapy. This clinical picture is rare and a recurrence-free survival of 8 years is remarkable.

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Section: Discussionmentioning

confidence: 52%

Unusual presentation of a late-onset recurrence of malignant peritoneal mesothelioma

et al. 2017

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“…Even though inguinal hernia surgery in children is delayed due to some social reasons, any practitioner does not encounter a malignancy that develops from the hernia sac. In the literature, however, mesothelioma case arising from IH sac have been encountered in patients who were at adult ages [1][2][3][4]17,18]. Therefore, the increased mesothelial proliferation in the IH sac would seem to be a predecessor of such malignancy for IH patients at very low rates theoretically in any period of their life.…”

Section: Resultsmentioning

confidence: 99%

Histopathological Fate in the Inguinal Hernia Sac in the Children

Yaşar¹

2018

Int J Pediatr Res

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Background/Purpose: Obliteration of the processus vaginalis during the fetal growth begins with a transient decrease in sympathetic tonus and then ends with smooth muscle cells (SMCs) undergoing apoptosis. Otherwise, an inguinal hernia (IH) occurs due to the defective obliteration. Although the mechanism in the formation of an inguinal hernia has been elucidated by many investigations, it has not been investigated whether proliferation in the IH sac cells which would lead to the benign or malignant process. In this study, we aimed to examine whether the proliferative changes in the cells of IH sac would be a histopathological precursor to any process. Methods: We obtained fifty (male 25, female 25) samples of the IH sac from patients (study group) during operations. Control groups were formed from twelve parietal peritoneum samples (male 4, female 8) undergoing laparotomy for various reasons, and two processus vaginalis samples obtaining from 2 boys. Samples were evaluated regarding mesothelial, smooth muscle, neuronal, adipose, and vascular tissue proliferation as well as inflammation and congestion. Histopathological evaluation was made with H&E staining. Immunohistochemical evaluation was performed with PCNA and HBME-1 known the proliferative and the mesothelial marker, respectively. Results: There were significantly increased mesothelial, vascular, nerve, and SMC proliferation in the study groups compared with those of control groups (p < 0.05). The expression of HBME-1 and PCNA was significantly increased (p < 0.05) in control groups compared with those of controls. Conclusions: We determined that the proliferation of SMCs increased in the IH sac as in previous studies. We also found the increased proliferation in the mesothelial cells together with the increased HBME-1 and PCNA expressions in the IH sac. These alterations may be an initiator of a benign or malignant process by which would be able to develop in the IH sac.

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“…To date, only a few cases of peritoneal metastasis in an inguinal hernia are reported in the literature. 8,9 When considering more specifically colorectal carcinomatosis in a groin hernia, the experience is even scarcer. 10 The utility of PET-CT in this particular situation was acknowledged, 8 and might help to differentiate a benign hernia from a malignant nodule.…”

Section: Discussionmentioning

confidence: 99%

Localized peritoneal carcinomatosis mimicking an irreducible left inguinal hernia

Buchs

Bloemendaal

Guy

2016

annals

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Perforated colonic cancers are not rare and leave patients at risk of developing peritoneal carcinomatosis. We present a 68-year-old male patient with a perforated transverse colonic tumour who underwent emergency extended right hemicolectomy. He made an uneventful postoperative recovery, and received adjuvant chemotherapy. Unfortunately, a routine positron emission tomography-computed tomography scan 16 months later demonstrated an fluorodeoxyglucose-avid nodule in the left scrotum associated with an irreducible left inguinal hernia that contained sigmoid colon. At laparotomy, the discovery of isolated peritoneal recurrence in the hernia sac was unexpected, given the absence of local recurrence in the region of the original transverse colon cancer perforation. The etiology therefore remains uncertain, but one may speculate that cell implantation occurred within the hernia sac at the initial emergency laparotomy. Whilst PC is not rare, its management and its preoperative diagnosis in particular remain challenging. Only 40% of patients can be diagnosed by imaging modalities and, in many of them, PC will be found only at the time of surgery. 1 We present an interesting case of peritoneal recurrence, mimicking an irreducible inguinal hernia. Case presentationA 68-year-old male with a known left inguinal hernia was admitted with acute abdominal pain and peritonitis. Abdominal computed tomography (CT) identified a perforated transverse colonic tumour. He underwent emergency extended right hemicolectomy, abdominal washout, curettage and omental obliteration of a cavity in the left upper quadrant, and received a primary ileocolic anastomosis. He made an uneventful postoperative recovery. Pathological examination showed a Dukes' B (pT4N0Ly1V1R0) adenocarcinoma and the patient received an adjuvant FOLFIRI chemotherapy regimen.Sixteen months later, routine positron emission tomography-computed tomography (PET-CT) scan demonstrated an fluorodeoxyglucose-avid nodule in the left hemiscrotum that was associated with both a left inguinal hernia containing sigmoid colon and a further nodule at the neck of the scrotum (Figures 1 and 2). Clinically, the hernia was irreducible, although there was no sign of obstruction or strangulation. There was no obvious testicular mass. A flexible sigmoidoscopy did not reveal any intraluminal colonic lesion.At laparotomy, and following reduction of the sigmoid colon out of the hernia sac, a nodule was found on the sigmoid serosa, and another at the neck of the sac adjacent to the pubic tubercle. Macroscopic disease was not seen anywhere else in the abdomen. On-table colonoscopy confirmed the absence of mucosal disease, and a limited segmental sigmoid resection, preserving the inferior mesenteric artery (IMA), and a separate resection of the peritoneal sac and second nodule were performed. Metastatic adenocarcinoma was confirmed microscopically in the two nodules. While three mesenteric lymph nodes were also positive for adenocarcinoma, no luminal cancer was detected. All disease was i...

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Primary Malignant Peritoneal Mesothelioma in an Incarcerated Groin Hernia: Report of a Case

Cited by 15 publications

References 11 publications

Unusual presentation of a late-onset recurrence of malignant peritoneal mesothelioma

Unusual presentation of a late-onset recurrence of malignant peritoneal mesothelioma

Histopathological Fate in the Inguinal Hernia Sac in the Children

Localized peritoneal carcinomatosis mimicking an irreducible left inguinal hernia

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