A Case of Renal Cell Carcinoma Diagnosed after Inguinal Hernia Surgery

Abstract

Inguinal hernial sac tumors within inguinal hernias are relatively rare. We report a case of renal cell carcinoma metastasizing into an inguinal hernia sac. An 89–year old man with a right inguinal mass found a year earlier underwent surgery in March 2007 for right inguinal hernia. An 80–mm solid tumor connected to the omentum and sac was removed simultaneously with hernia repair using a mesh plug. Histopathological examination showed renal cell carcinoma metastasis. Postoperative computed tomography (CT) suggested a 50 mm tumor in the left kidney, with generalized lymphadenopathy, ascites, and increased peritoneal concentration. The diagnosis was systemic lymph node metastasis from left renal cancer and peritonitis carcinomatosa resulting in Stage IV renal cancer for which the man and his family requested no further treatment. He died of the primary disease 3 months thereafter. Histopathological examination is essential in cases in which the hernia sac and the content are macroscopically unusual.