# The Incidental Diagnosis of a Hodgkin Lymphoma Following Elective Robotic-Assisted Inguinal Hernia Repair: A Case Report

## TL;DR

A patient's routine hernia surgery led to the unexpected discovery of Hodgkin lymphoma, highlighting the importance of careful intraoperative evaluation.

## Contribution

This case report highlights the rare incidental detection of Hodgkin lymphoma during hernia repair and emphasizes the importance of evaluating atypical findings during surgery.

## Key findings

- An enlarged femoral mass discovered during hernia repair was identified as stage IIIA Hodgkin lymphoma.
- The patient received chemotherapy and showed no recurrence during follow-up.
- Incidental malignancy detection during routine surgery can improve patient outcomes through early intervention.

## Abstract

Hodgkin lymphoma (HL) is a rare malignancy, typically diagnosed via investigations prompted by clinical symptoms or imaging findings. In contrast, inguinal hernia repair, one of the most common elective surgeries, is rarely associated with malignancy. This case report describes an incidental discovery of stage IIIA HL during routine robotic-assisted laparoscopic hernia repair, underscoring the importance of thoroughly evaluating atypical intraoperative observations, as early recognition enables timely diagnosis and intervention. A 46-year-old male underwent elective robotic-assisted laparoscopic repair of a left inguinal hernia. Intraoperatively, an enlarged femoral mass, later identified as a retroperitoneal lymph node, was resected. Pathology confirmed stage IIIA HL. The patient received six cycles of chemotherapy and has since shown no recurrence during follow-up.

HL accounts for approximately 10% of all lymphomas, with several histological subtypes. Although hernia repairs are routine, incidental malignancies are rare. This report reinforces the need for vigilance and histopathological assessment of atypical findings, even during standard procedures. Early detection facilitates timely treatment and improves survival. Incidental detection of malignancy during routine surgery can significantly impact patient outcomes. This report demonstrates the importance of meticulous intraoperative assessment, enabling early intervention, improved survival, and reduced recurrence risk. Documenting such findings is essential to inform surgical best practices.