Testicle in Inguinal Canal of a 62 Year Old Woman with Strangulated Hernia

Abstract

The presence of the male gonad in a patient who appears outwardly as a female is a hallmark of testicular feminization, where peripheral target organs are resistant to androgens. A 62-yearold woman was admitted to the hospital with a bulk in her right inguinal region complaining of pain. Due to the presence of oedematous small intestine segments, which became prolapsed from the right inguinal duct in the superficial ultrasonography of the right inguinal region, herniorrhaphy under emergency conditions was performed; after herniorrhaphy, a 1x1 cm mass was found to be stuck to a round ligament and hernia sac, and the mass was evaluated as reactive lymph node. The mass was excised and histopathological examination revealed a testicular tissue. Testicular feminization syndrome is observed in 1 out of 20.000 to 60.000 women in the general population and in between 0.8% and 2.4% of girls who have inguinal hernia. In light of this case, we agree that testicular feminization should be considered in cases of finding a bulk in the inguinal canal at every age. Additionally, to avoid medicolegal problems, providing necessary information and counseling is critically important.