Metastatic Sigmoid Colon Cancer Presented as Incarcerated Inguinal Hernia – Case Report

Abstract

Inguinal hernia containing metastases of intestinal adenocarcinoma is a rare finding. Metastases of sigmoid colon adenocarcinoma are most commonly found inside the hernia sac. Older males are more often affected. A 84-years old male patient  presented with pain in the right groin, highly suspicious to be an incarcerated right inguinal hernia. During emergency operation we found mesenteric metastases of the small intestine, that was incarcerated inside the inguinal hernia sac. Histopathological result of biopsy has shown metastasis of intestinal type adenocarcinoma. Additional diagnostics has shown sigmoid colon adenocarcinoma, peritoneal carcinosis and liver metastases. Primary tumor was locally advanced and un resectable, groin hernia was repaired using Bassini technique and diverting colostomy was performed. Due to advanced metastatic disease, symptomatic treatment was advised. In patients presenting with groin hernia, when suspected malignant lesion is found within hernia sac, histopathologic verification of the lesion is needed. Further diagnostics is also indicated for the definition of the primary tumor.