# An Amyand Hernia With Concurrent Appendicitis Secondary to a Neuroendocrine Neoplasm: A Case Report

## TL;DR

A rare case of a 15-year-old with appendicitis in an inguinal hernia caused by a neuroendocrine tumor is reported, highlighting the importance of considering cancer in such diagnoses.

## Contribution

This case report presents a rare combination of Amyand’s hernia, appendicitis, and a neuroendocrine tumor, emphasizing diagnostic and management considerations.

## Key findings

- A neuroendocrine tumor was identified as the cause of appendicitis within an inguinal hernia in a 15-year-old male.
- Curative treatment with caecectomy showed no residual malignancy after surgery.
- The case highlights the need to consider underlying malignancy in atypical appendicitis presentations.

## Abstract

Amyand’s hernia (AH) describes the rare instance of a vermiform appendix within an inguinal hernia. Primary appendiceal neoplasms are also rare with the majority of cases being found incidentally during routine histopathology. This case reports the management of a 15-year-old male, who presented to the emergency department with acute appendicitis located within an indirect right inguinal hernia, which was ultimately secondary to a neuroendocrine tumor (NET) with serosal involvement. Intraoperative findings included macroscopic appendicitis with no evidence of perforation. Histopathology returned as a neuroendocrine tumor (pT4) with involved proximal margin and curative treatment was undertaken with a caecectomy which returned no residual malignancy. Key considerations include management options of peritoneal spread within the inguinal canal and recommended management NET in the context of an AH. It is important to understand the varied presentations of common surgical diagnosis such as appendicitis and underlying malignancy should always be considered a differential.