Inflammatory Pseudotumor in an Irreducible Inguinal Hernia

Abstract

Background: The aim of this article is to report an unusual case of inflammatory pseudotumor (IPT) that caused irreducibility of an inguinal hernia mimicking a tumour in the process. Case report: A 64-year-old man presented with a 2year history of reducible groin swelling which had progressively increased in size. The swelling had become irreducible 3 months prior to admission but apart from loss of weight, there were no other associated symptoms. He was anaemic (Hb 11 g/dL). At operation, a large, hard left inguinoscrotal hernia was encountered. This raised the suspicion of a tumour and therefore the testis and large mass were mobilised and resected along with an adherent segment of small bowel. He had end to end anastomosis of small bowel and modified Shouldice repair. He was well enough to self-discharge two days later and was well when seen two weeks postoperatively. The histological examination of the resected specimen confirmed an IPT and a normal testis. Discussion: The diagnosis and management of IPT remains elusive, however current evidence support histology as the mainstay of diagnosis and surgical resection as the first line of treatment. Conclusion: Following surgical resection of IPT, it might be beneficial to follow up all cases to evaluate for recurrence and prompt management.