Adenocarcinoma of Mullerian Origin Found Through an Elective Inguinal Hernia Resection: A Case Report

TL;DR

A case report describes finding ovarian cancer in a hernia during a routine surgery in an asymptomatic woman.

Contribution

Highlights the rare occurrence of diagnosing ovarian cancer through hernia excision and emphasizes the importance of histological examination.

Findings

Ovarian adenocarcinoma was found incidentally in an umbilical hernia of an asymptomatic patient.

The tumor was identified as high-grade serous carcinoma with a background of serous tubal intraepithelial carcinomas.

Histological examination of hernias is crucial even in asymptomatic patients to detect malignancies.

Abstract

We report an asymptomatic 59-year-old female undergoing an elective umbilical hernia excision who was found to have an ovarian adenocarcinoma within the excised hernia. Patients are rarely diagnosed with cancer after an umbilical hernia excision. An excised hernia is rarely the means for an initial diagnosis of cancer. We describe a case of an ovarian carcinoma incidentally found through an umbilical hernia excision with consequential treatment with neoadjuvant platinum-based chemotherapy followed by debulking surgery with a total hysterectomy with bilateral salpingo-oophorectomy with a transoperative pathology report of a high-grade serous carcinoma located in the left fimbrial frond surrounded by a background of serous tubal intraepithelial carcinomas. This case demonstrates the need to perform histological examinations of all excised hernias, even in asymptomatic patients, as malignancy can be found inside a hernia, and it emphasizes the importance of considering adenocarcinomas of Mullerian origin in the differential diagnosis of a malignancy found in a hernia in an asymptomatic female patient.

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