腹腔鏡下観察が有用であった巨大卵巣ヘルニアの1例

抄録

Objective: An ovarian inguinal hernia is extremely rare in adults, and it is usually associated with developmental defects of the genital tract. We present a case of a 95-year-old female with an inguinal hernia containing a huge ovarian tumor (20 cm in diameter).
Patient: Because of the large inguinal bulge, the patient experienced difficulty in walking. She recalled that the inguinal bulge was approximately 2 cm in diameter when she first noticed it 35 years ago; in addition, it was reducible at that time. Abdominal CT scan revealed a solid inguinal tumor, which was possibly receiving its blood supply from the left ovarian artery. Laparoscopic exploration revealed that the hernia sac was covered by dense adhesions and contained the solid ovarian tumor as well as the left pelvic infundibular ligament. Following adhesiolysis, the ligament was transected laparoscopically. The ovarian tumor was removed through a skin incision. The redundant skin was trimmed; then, an open hernia repair was performed, using woven mesh. Her postoperative course was uneventful, and she was discharged on the fifth postoperative day. The histopathologic diagnosis of the tumor was a Sertoli cell tumor of the ovary.
Conclusions: A steadily enlarging ovarian neoplasm can become incarcerated in the inguinal canal for a long period of time without strangulation occurring. Although it is rare, an ovarian inguinal hernia should be considered when a groin mass is encountered in an adult female.