Abstract:
Retroperitoneal masses presenting as an inguinal hernia are rare conditions.
PRESENTATION OF CASE: A 53 year old male admitted with the symptoms of weight loss, abdominal
discomfort and left sided recurrent inguinal hernia. Physical examination demonstrated an abdominal
mass in the left flank and an irreducible, painless scrotal mass. He had a history of left sided inguinal
hernia surgery six years ago. Computed tomography revealed a large enhancing left sided retroperitoneal
mass invading the colon, pancreas and kidney and it was going down towards the left scrotum. Unblock
tumor resection including the neighboring organs (left kidney, left colon, distal pancreas with spleen)
was performed. Scrotal extension of the tumor was also excised and the inguinal canal was repaired
primarily. Histopathology of the mass was myxoid-liposarcoma. The patient has disease free, without
hernia recurrence but poor in renal function after twenty months follow-up.
DISCUSSION: Large retroperitoneal tumors may grow towards the inguinal region and they can mimic an
inguinal hernia.An irreducible, painless and hard scrotal mass should be considered from this perspective.