Locally advanced carcinoma of the cecum presenting as a right inguinal hernia: a case report and review of the literature.
BACKGROUND
An inguinal hernia is a common surgical disease in elderly patients, but an association with intra-abdominal malignancies is rare.


METHODS
We report a case of a 78-year-old Caucasian woman presenting with a right inguinal mass suspected to be an irreducible hernia. A computed tomography scan showed the presence of the cecum in her inguinal canal, with an irregular thickening of the cecal wall suggesting a neoplasm within the inguinal hernia. A colonoscopy was not completed owing to the huge involvement of the cecum into the hernia sac. A laparotomy was performed, at which time the cecum was herniated through her right inguinal canal and the cecal tumor had infiltrated her abdominal wall and femoral artery. A right inguinal incision was necessary for good vascular control and to carry out an en bloc resection of the tumor with the inguinal wall. A right colectomy was performed and the inguinal wall repaired. The postoperative course was uneventful and our patient received adjuvant radiochemotherapy.


CONCLUSIONS
We describe a rare case of a locally advanced cecal tumor presenting as a right inguinal hernia. Both diagnosis and surgical treatment in elderly patients represent a challenge for the surgeon in cases of aggressive tumors as reported in this paper.
Division of General Surgery and Organ Transplantation, S, Camillo Hospital, POIT S, Camillo-INMI Lazzaro Spallanzani, Circonvallazione Gianicolense 87, Rome, Italy. robmeni@tiscali.it.
Roberto Luca
RL
Meniconi
Giovanni
G
Vennarecci
Pasquale
P
Lepiane
Andrea
A
Laurenzi
Roberto
R
Santoro
Marco
M
Colasanti
Mario
M
Antonini
Giuseppe Maria
GM
Ettorre