Annals of Medicine and Surgery · 9 authors, 2 centres
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A 68-year-old man with a left inguinal hernia was found intraoperatively to have a sigmoid colon adenocarcinoma within the hernial sac, which was managed with synchronous resection, colostomy, and subsequent chemotherapy with no recurrence at one year.
This case report describes a 68-year-old man who presented with a left inguinal swelling of several years' duration that had recently increased in size. Preoperative diagnosis was an uncomplicated left inguinal hernia. During elective hernia repair, a hard mass was identified within the sigmoid colon in the hernial sac. The mass was resected from the same hernia defect with colostomy creation. Histopathological analysis revealed a moderately differentiated adenocarcinoma (G2) invading the muscularis propria with regional lymph node involvement (5 of 12 nodes positive), staged as PT3N2Mx. Postoperative CT scan showed no distant metastasis. This report highlights the rarity of colorectal cancer presenting as an inguinal hernia and underscores the importance of intraoperative vigilance during hernia repair.
