title: Intrasaccular caecal adenocarcinoma presenting as enlarging right inguinoscrotal hernia.
abstract: BACKGROUND
  Colorectal cancer and inguinal hernias are both common surgical pathologies in the elderly but rarely co-exist. Where the conditions overlap, there can be difficulties in both diagnosis and treatment.
  
  
  METHODS
  A 78 year old man with unexplained iron deficiency anaemia was investigated for gastrointestinal cancer. He was found to have enlarging bilateral inguinoscrotal hernias. CT colonoscopy revealed a herniated caecal carcinoma contained within the scrotum. An open excision was performed.
  
  
  CONCLUSIONS
  Iron deficiency anaemia without obvious bleeding is associated with colorectal cancer and should be thoroughly investigated. Asymptomatic inguinal hernias are often ignored by patients. However, a change in an existing hernia may be associated with neoplasia.
  
  
  CONCLUSIONS
  Dual pathology raises new difficulties in assessment, investigation and management of colorectal cancer.
authors.affiliation: Department of Colorectal Surgery, Salisbury District Hospital, Odstock Road, Salisbury, Wilts SP2 8BJ, UK.
authors.forename: Max
authors.initials: M
authors.lastname: Marsden
authors.affiliation: Department of Colorectal Surgery, Salisbury District Hospital, Odstock Road, Salisbury, Wilts SP2 8BJ, UK.
authors.forename: Nathan
authors.initials: N
authors.lastname: Curtis
authors.affiliation: Department of Radiology, Salisbury District Hospital, Odstock Road, Salisbury, Wilts SP2 8BJ, UK.
authors.forename: Shaun
authors.initials: S
authors.lastname: McGee
authors.affiliation: Department of Colorectal Surgery, Salisbury District Hospital, Odstock Road, Salisbury, Wilts SP2 8BJ, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Bracey
authors.affiliation: Department of Colorectal Surgery, Salisbury District Hospital, Odstock Road, Salisbury, Wilts SP2 8BJ, UK.
authors.forename: Graham
authors.initials: G
authors.lastname: Branagan
authors.affiliation: Department of Colorectal Surgery, Salisbury District Hospital, Odstock Road, Salisbury, Wilts SP2 8BJ, UK. Electronic address: simon.sleight@salisbury.nhs.uk.
authors.forename: Simon
authors.initials: S
authors.lastname: Sleight
keywords: Caecal adenocarcinoma; Colorectal cancer; Computer tomography colonography; Inguinal hernia