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Adhikari S, Bhatta OP, Bhetwal P, Awasthi S. Encysted spermatic cord hydrocele: A case series. Int J Surg Case Rep 2024; 118:109619. [PMID: 38626639 PMCID: PMC11035082 DOI: 10.1016/j.ijscr.2024.109619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 04/18/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Encysted spermatic cord hydrocele is a rare anomaly characterized by obstruction of processus vaginalis closure. Clinically, it presents as a swelling in the inguinal region extending to the upper scrotum and does not communicate with the peritoneal cavity. It is often mistaken for indirect inguinal hernias, inguinal lymphadenopathy, undescended testis, and primary tumors of the cord in infants and children, making the diagnosis challenging. CASE PRESENTATION We report the cases of five male patients aged nine months to 12 years who presented with painless swelling on the right side of the scrotal region. Physical examination revealed firm masses in the right inguinal region with positive transillumination, negative cough impulse tests, and irreducibility. Inguinal and scrotal ultrasonography showed an anechoic cystic lesion with thin walls, without any signs suggestive of a hernia. Patients were diagnosed with encysted spermatic cord hydrocele and advised to undergo cyst excision. The postoperative periods were uneventful, and expected recovery was observed at one-week and one-month follow-ups. CLINICAL DISCUSSION Encysted spermatic cord hydroceles are rare causes of painless inguinal swelling. The medical history and clinical findings can be used to establish a diagnosis, which can be confirmed using ultrasonography. Management depends on differentiating between spermatic cord hydrocele and scrotal hydrocele and involves considering the type. Treatment options range from conservative measures to surgery, particularly for non-communicating hydroceles that persist beyond 12-18 months or enlarge in size. CONCLUSION Encysted hydrocele of the cord is rare and is often mistaken for indirect inguinal hernias in infants and children. This similarity makes the diagnosis challenging and necessitates vigilance from clinicians. Surgical intervention results in optimal outcomes, especially in cases where the hydrocele persists beyond 12-18 months or with size progression.
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Affiliation(s)
| | | | | | - Sachin Awasthi
- Department of Emergency Medicine, Yashoda Hospital, Banke, Nepal
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2
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Atri S, Zaiem A, Sebai A, El Aifia R, Haddad A, Kacem M. Torsion of funiculocele presenting as an incarcerated hernia: A rare case. Int J Surg Case Rep 2024; 117:109547. [PMID: 38522305 PMCID: PMC10973810 DOI: 10.1016/j.ijscr.2024.109547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/10/2024] [Accepted: 03/14/2024] [Indexed: 03/26/2024] Open
Abstract
INTRODUCTION Inguinal hernia is common, but the groin area can host various pathologies. Distinguishing clinically between hernias and rare conditions like torsion of funiculocele poses challenges due to similar presentations. CASE PRESENTATION A 50-year-old man, with a 10-year-history of a groin mass, presented with a painful groin mass, initially diagnosed as a strangulated hernia. In surgery, a torsion of a cyst was identified, and it was attached to the spermatic cord. A detorsion of the cyst and an excision were successfully performed. The patient recovered well with no recurrence. DISCUSSION The most common causes of acute groin pain are injury, incarcerated hernia, kidney stone and bone fracture. Additionally, funiculocele can cause groin pain or discomfort. Funiculocele, a rare congenital anomaly, typically affects pediatric patients. A torsion of funiculocele is easily confused with an incarcerated hernia. Ultrasonography plays a crucial role in confirmation. Although unusual, a torsion of a cyst can occur, necessitating surgical excision. CONCLUSION Funiculocele in adults, mimicking hernias, is rare but requires timely surgical intervention to prevent complications. Awareness of this anomaly is vital for accurate diagnosis and appropriate management.
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Hoang VT, Van HAT, Hoang TH, Nguyen TTT, Trinh CT. A Review of Classification, Diagnosis, and Management of Hydrocele. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:599-607. [PMID: 38010662 DOI: 10.1002/jum.16380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/15/2023] [Indexed: 11/29/2023]
Abstract
This article summarizes and updates a number of issues related to hydrocele including anatomy, embryology, classification, etiology, clinical manifestations, imaging findings, and management. Hydrocele is an abnormal collection of serous fluid between the parietal and visceral layers arising from the mesothelial lining of the tunica vaginalis that surrounds the testis and spermatic cord directly. Hydroceles result from an imbalance of secretion and reabsorption of fluid from the tunica vaginalis. Hydroceles can be divided into two types as primary and secondary. The diagnosis should be based on medical history, clinical manifestations, and imaging studies. Understanding the causes and types of hydroceles is useful for accurately diagnosing and treatment strategy. Hydroceles can be managed by conservative treatment, fluid aspiration, or hydrocelectomy.
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Affiliation(s)
- Van Trung Hoang
- Department of Radiology, Thien Hanh Hospital, Buon Ma Thuot, Vietnam
| | - Hoang Anh Thi Van
- Department of Radiology, Thien Hanh Hospital, Buon Ma Thuot, Vietnam
| | - The Huan Hoang
- Department of Radiology, Thien Hanh Hospital, Buon Ma Thuot, Vietnam
| | | | - Cong Thao Trinh
- Department of Radiology, FV Hospital, Ho Chi Minh City, Vietnam
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4
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Jaweesh S, Jaweesh M, Mahgaa MT, Ali S, Alfandi A, Mahmoud MZ. Diagnosis and management of a rare case of encysted hydrocele of spermatic cord: Case report and literature review. Int J Surg Case Rep 2024; 115:109299. [PMID: 38277986 PMCID: PMC10839639 DOI: 10.1016/j.ijscr.2024.109299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 01/28/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE A hydrocele is typically a non-cancerous condition that arises from the accumulation of fluid between the layers of the vaginal process. Diagnosis primarily involves a physical examination. In instances where the condition is mistaken for other pathological conditions, additional investigations may be undertaken. Surgical intervention is typically deferred until after the age of one year, unless the hydrocele is significantly large. CASE PRESENTATION A case was presented of a 4-year-old boy who was referred to the hospital with a suspected deep inguinal hernia. Upon examination, it was determined that the mass was actually an encysted hydrocele of spermatic cord. The patient underwent a minimally invasive surgery to remove the spermatocele, and the procedure was successful. CLINICAL DISCUSSION This emphasizes the importance of obtaining a detailed patient history and conducting a comprehensive physical examination, which often provide sufficient information to make a diagnosis. In many instances, these initial steps can spare patients from undergoing additional tests that may be invasive or pose unnecessary risks. CONCLUSION It is important to note that in cases of hydroceles, conservative treatment, such as observation, is the primary approach before the age of one year. Surgery is typically reserved for older children or those with large hydroceles.
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Affiliation(s)
- Shkri Jaweesh
- Faculty of Medicine, Al-Sham Private University, Damascus, Syria.
| | | | | | - Sanaa Ali
- Faculty of Medicine, Al-Sham Private University, Damascus, Syria
| | - Abdullah Alfandi
- Faculty of Medicine, Al-Sham Private University, Damascus, Syria
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Ravikanth R. Acquired encysted hydrocele of the cord secondary to trauma in a child: Sonological appearances of a rare entity. J Med Ultrasound 2022; 30:65-66. [PMID: 35465593 PMCID: PMC9030356 DOI: 10.4103/jmu.jmu_73_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/30/2020] [Accepted: 07/06/2020] [Indexed: 11/25/2022] Open
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6
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Mirjalili SAM, Maleki H, Gholami J. Testis with no tunica vaginalis: A case report and literature review. Int J Reprod Biomed 2021; 19:851-852. [PMID: 34723065 PMCID: PMC8548749 DOI: 10.18502/ijrm.v19i9.9718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 08/02/2020] [Accepted: 02/08/2021] [Indexed: 12/02/2022] Open
Affiliation(s)
| | - Hadi Maleki
- Department of Urology, Shahid Madani Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Javid Gholami
- Urologist Gonbad Kavus Hospital, Golestan University of Medical Science, Gorgan, Iran
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7
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Using Point-of-Care Ultrasound to Characterize Acute Inguinal Swelling of Young Children in the Pediatric Emergency Department. Pediatr Emerg Care 2020; 36:304-307. [PMID: 32011551 DOI: 10.1097/pec.0000000000002014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Acute inguinal swelling in young children is frequently assumed to be an inguinal hernia, often prompting a bedside reduction attempt. We report 3 cases of inguinal swelling where the use of point-of-care ultrasound changed the patients' management by identifying an alternate diagnosis, thus avoiding unnecessary and painful procedures as well as their associated sedation risks.
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The challenging sonographic inguinal canal evaluation in neonates and children: an update of differential diagnoses. Pediatr Radiol 2017; 47:461-472. [PMID: 27832304 DOI: 10.1007/s00247-016-3706-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 07/24/2016] [Accepted: 09/09/2016] [Indexed: 10/20/2022]
Abstract
Bulging of the inguinal region is a frequent complaint in the pediatric population and sonographic findings can be challenging for radiologists. In this review we update the sonographic findings of the most common disorders that affect the inguinal canal in neonates and children, with a focus on the processus vaginalis abnormalities such as congenital hydroceles, indirect inguinal hernias and cryptorchidism, illustrated with cases collected at a quaternary hospital during a 7-year period. We emphasize the importance of correctly classifying different types of congenital hydrocele and inguinal hernia to allow for early surgical intervention when necessary. We have systematically organized and illustrated all types of congenital hydrocele and inguinal hernias based on embryological, anatomical and pathophysiological findings to assist readers in the diagnosis of even complex cases of inguinal canal ultrasound evaluation in neonates and children. We also present rare diagnoses such as the abdominoscrotal hydrocele and the herniation of uterus and ovaries into the canal of Nuck.
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Ramanathan S, Palaniappan Y, Sheikh A, Ryan J, Kielar A. Crossing the canal: Looking beyond hernias — Spectrum of common, uncommon and atypical pathologies in the inguinal canal. Clin Imaging 2017; 42:7-18. [DOI: 10.1016/j.clinimag.2016.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 10/25/2016] [Accepted: 11/04/2016] [Indexed: 01/09/2023]
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Rafailidis V, Varelas S, Apostolopoulou F, Rafailidis D. Nonobliteration of the Processus Vaginalis. Sonography of Related Abnormalities in Children. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:805-818. [PMID: 26960801 DOI: 10.7863/ultra.15.04060] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The objective of this pictorial essay is to systematically classify processus vaginalis– related disorders in the light of embryology and present illustrative sonograms with corresponding diagrams. Failure of the processus vaginalis to obliterate during gestation results in a wide spectrum of anomalies, including communicating and noncommunicating hydroceles and inguinal and inguinoscrotal hernias, along with other related disorders of the genital system. There are varying classifications in the literature regarding the aforementioned entities. Proper and timely diagnosis of these entities is essential, given the differences in treatment. Although physical examination can narrow the differential diagnosis, sonography plays an essential role in establishing the diagnosis.
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11
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Inguinoscrotal and inguinolabial swelling in infancy: Role of ultrasound. AFRICAN JOURNAL OF UROLOGY 2015. [DOI: 10.1016/j.afju.2015.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Patil V, Shetty SMC, Das S. Common and Uncommon Presentation of Fluid within the Scrotal Spaces. Ultrasound Int Open 2015; 1:E34-40. [PMID: 27689151 DOI: 10.1055/s-0035-1555919] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 06/29/2015] [Indexed: 01/18/2023] Open
Abstract
Ultrasonography(US) of the scrotum has been demonstrated to be useful in the diagnosis of fluid in the scrotal sac. Grayscale US characterizes the lesions as testicular or extratesticular and, with color Doppler, power Doppler and pulse Doppler, any perfusion can also be assessed. Cystic or encapsulated fluid collections are relatively common benign lesions that usually present as palpable testicular lumps. Most cysts arise in the epidydimis, but all anatomical structures of the scrotum can be the site of their origin. US may suggest a specific diagnosis for a wide variety of intrascrotal cystic and fluid lesions and appropriately guide therapeutic options. The paper reviews the current knowledge of ultrasound in conditions with fluid in the testis and scrotum. The review presents the applications of ultrasonography in the diagnosis of hydrocele, testicular cysts, epididymal cysts, spermatoceles, tubular ectasia, hernia and hematoceles. The aim of this paper is to provide a pictorial review of the common and uncommon presentation of fluid within the scrotal spaces.
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Affiliation(s)
- V Patil
- Radiodiagnosis, JSS Medical College, Mysore, India
| | - S M C Shetty
- Radiodiagnosis, JSS Medical College, Mysore, India
| | - S Das
- Radiodiagnosis, JSS Medical College, Mysore, India
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13
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D M, M KT, Khan DM. Encysted Spermatic Cord Hydrocele in a 60-year-old, Mimicking Incarcerated Inguinal Hernia: A Case Report. J Clin Diagn Res 2014; 8:153-4. [PMID: 24701514 DOI: 10.7860/jcdr/2014/6998.4039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 12/20/2013] [Indexed: 11/24/2022]
Abstract
Hydrocele of spermatic cord is caused by defect in closure of the processus vaginalis, as the testicles descend into the scrotum during foetal development. It usually occurs in infancy and childhood. There are two types of hydrocele of spermatic cord. Encysted type is caused by defective closure at both proximal and distal ends of processus vaginalis and it does not communicate with the peritoneal cavity. Funicular type is caused by defective closure of only distal end of tunica vaginalis and it communicates with the peritoneal cavity. The encysted type can be confused clinically with incarcerated inguinal hernia, inguinal lymphadenopathy, undescended testis and primary tumours of cord like lipoma. We are presenting a case of encysted hydrocele of spermatic cord in a 60-year-old male, which clinically mimicked incarcerated inguinal hernia.
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Affiliation(s)
- Manimaran D
- Associate Professor, Department of Pathology, Shri Sathya Sai Medical College and Research Institute , Tiruporur, Tamilnadu, India
| | - Karthikeyan T M
- Associate Professor, Department of Pathology, Melmaruvathur Adhiparasakthi Institute of Medical Science and Research , Melmaruvathur, Tamilnadu, India
| | - Dost Mohamed Khan
- Associate Professor, Department of Pathology, Shri Sathya Sai Medical College and Research Institute , Tiruporur, Tamilnadu, India
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14
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Williamson ZC, Epelman M, Daneman A, Victoria T, Chauvin N, Oudjhane K, Navarro OM. Imaging of the inguinal canal in children. Curr Probl Diagn Radiol 2013; 42:164-79. [PMID: 23795995 DOI: 10.1067/j.cpradiol.2013.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The inguinal canal is often seen at the edge of the field of view on plain radiography, computed tomography, or magnetic resonance imaging and may often not be scanned when performing sonography of the scrotum or abdomen. As a result, pathology in this anatomical region may be easily overlooked. The peculiar embryology of the inguinal canal makes the identification of pathology in the inguinal region significant, as some of the processes that take place within the scrotum may originate in the abdomen, and vice versa. This article reviews the relevant embryology of the inguinal canal, discusses abdominal and scrotal conditions that involve the inguinal region, and illustrates associated pathology.
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15
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16
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Singh AK, Kao S, D'Alessandro M, Sato Y. Case 164: Funicular type of spermatic cord hydrocele. Radiology 2011; 257:890-2. [PMID: 21084419 DOI: 10.1148/radiol.10091019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Achint K Singh
- Department of Radiology, University of Iowa, Iowa City, Iowa, USA.
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17
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Hydrocele of the Spermatic Cord in Infants and Children: Its Particular Characteristics. Urology 2010; 76:82-6. [DOI: 10.1016/j.urology.2010.02.062] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 02/22/2010] [Accepted: 02/23/2010] [Indexed: 11/22/2022]
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18
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Garriga V, Serrano A, Marin A, Medrano S, Roson N, Pruna X. US of the tunica vaginalis testis: anatomic relationships and pathologic conditions. Radiographics 2010; 29:2017-32. [PMID: 19926760 DOI: 10.1148/rg.297095040] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Extratesticular lesions are common incidental findings at ultrasonography (US) among men and boys. Most lesions originate from or depend on the tunica vaginalis, a mesothelium-lined sac with a visceral layer and a parietal layer. The tunica vaginalis is formed when the superior portion of the processus vaginalis closes during embryologic development. Abnormal closure of the processus vaginalis leads to congenital anomalies of the tunica vaginalis, such as complete or partial patency of the processus vaginalis, spermatic cord hydrocele, and inguinoscrotal hernia. The proximity of the visceral layer to the testis explains the reactive involvement seen in epididymo-orchitis, with resultant pyocele or abscess formation. The tunica vaginalis also may be affected by inflammatory and traumatic disorders such as scrotal calculi, fibrous pseudotumor, or hematocele. These lesions manifest as solid or heterogeneous tumorlike masses. Lesions of mesothelial origin, such as adenomatoid tumor, tunica cyst, and mesothelioma, may involve the tunica vaginalis. Entrapped mesenchymal cells can lead to lipoma, leiomyoma, or sarcoma, although these tumors are uncommon in the tunica vaginalis. US is not useful for differentiating between benign and malignant tumors; however, some characteristic findings may help in planning the best surgical approach. Knowledge of the embryologic development, anatomic relationships, and pathologic disorders of the tunica vaginalis is essential to narrow the differential diagnosis of an extratesticular lesion. In most cases, US findings in combination with clinical assessment can indicate whether nonsurgical management or testis-sparing surgery is warranted.
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Affiliation(s)
- Victoria Garriga
- Department of Radiology, Hospital General de Granollers, Fundació Hospital-Asil de Granollers, Granollers, Spain.
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Bhosale PR, Patnana M, Viswanathan C, Szklaruk J. The inguinal canal: anatomy and imaging features of common and uncommon masses. Radiographics 2008; 28:819-35; quiz 913. [PMID: 18480486 DOI: 10.1148/rg.283075110] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A variety of benign and malignant masses can be found in the inguinal canal (IC). Benign causes of masses in the IC include spermatic cord lipoma, hematoma, abscess, neurofibroma, varicocele, desmoid tumor, air, bowel contrast material, hydrocele, and prostheses. Primary neoplasms of the IC include liposarcoma, Burkitt lymphoma, testicular carcinoma, and sarcoma. Metastases to the IC can occur from alveolar rhabdomyosarcoma, monophasic sarcoma, prostate cancer, Wilms tumor, carcinoid tumor, melanoma, or pancreatic cancer. In patients with a known malignancy and peritoneal carcinomatosis, the diagnosis of metastases can be suggested when a mass is detected in the IC. When peritoneal disease is not evident, a mass in the IC is indicative of stage IV disease and may significantly alter clinical and surgical treatment of the patient. A combination of the clinical history, symptoms, laboratory values, and radiologic features aids the radiologist in accurately diagnosing mass lesions of the IC. Supplemental material available at radiographics.rsnajnls.org/cgi/content/full/28/3/819/DC1.
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Affiliation(s)
- Priya R Bhosale
- Department of Radiology, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Box 368, Houston, TX 77030, USA.
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20
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Miller CR. Ultrasound in the Assessment of the Acute Abdomen in Children: Its Advantages and Its Limitations. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/j.cult.2007.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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21
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Yang DM, Kim HC, Lim JW, Jin W, Ryu CW, Kim GY, Cho H. Sonographic findings of groin masses. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2007; 26:605-14. [PMID: 17460003 DOI: 10.7863/jum.2007.26.5.605] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
OBJECTIVE The groin contents consist of the spermatic cord and its fascial coverings and vascular, nervous, and muscular structures. Abnormalities in the groin region are variable. The purpose of this image presentation is to describe the sonographic findings of the various kinds of groin lesions. METHODS We retrospectively reviewed the sonographic findings of various kinds of groin lesions. All sonographic examinations were performed with high-frequency (5- to 15-MHz) linear array transducers. RESULTS The most common abnormality in the groin was a hernia, which contains bowel loops, omental fat, and peritoneal fluid. The most common benign tumor of the inguinal region was a lipoma. Other benign tumors of the groin included leiomyomas, dermoid cysts, epidermoid cysts, and lymphangiomas. The most common primary malignant tumors in the inguinal region were sarcomas such as rhabdomyosarcoma and liposarcoma. Secondary malignant tumors of the inguinal regions were metastatic lymphomas and metastatic carcinomas of the lung, breast, ovary, and gastrointestinal tract. Hematomas and inflammation may occur in the inguinal region. CONCLUSIONS Although there was substantial overlap of sonographic findings in the various inguinal masses, clinical history and certain sonographic details can assist in making the correct diagnosis.
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Affiliation(s)
- Dal Mo Yang
- Department of Radiology, Kyung Hee University East-West Neo Medical Center, Seoul 134-090, Korea.
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22
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Castaldo ET, Williams EH, Dattilo J, Passman M, Naslund T, Guzman RJ. Common Femoral Vein Aneurysm Simulating an Inguinal Hernia. Am Surg 2005. [DOI: 10.1177/000313480507100711] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Common femoral vein aneurysms are rare, yet knowledge of this entity is important for the surgeon who performs hernia repairs. This is because common femoral vein aneurysms can simulate inguinal or femoral hernias, and misdiagnosis can lead to significant morbidity if treated incorrectly. To our knowledge, only five other cases of femoral aneurysms simulating inguinal or femoral hernias have been reported. We present the case of a 50-year-old male with inguinal pain and swelling who was found to have a common femoral vein aneurysm at surgical exploration for hernia repair. The etiology, diagnostic strategy, and management options for common femoral vein aneurysm are presented and are followed by recommendations for operative management. In the case of an unanticipated femoral aneurysm found during hernia repair, we recommend termination of the procedure followed by elective repair to be performed after appropriate diagnostic testing has been completed.
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Affiliation(s)
- Eric T. Castaldo
- Department of Surgery, Division of Vascular Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Eric H. Williams
- Department of Surgery, Division of Vascular Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jeffrey Dattilo
- Department of Surgery, Division of Vascular Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mark Passman
- Department of Surgery, Division of Vascular Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Thomas Naslund
- Department of Surgery, Division of Vascular Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Raul J. Guzman
- Department of Surgery, Division of Vascular Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
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Stickel WH, Manner M. Female hydrocele (cyst of the canal of Nuck): sonographic appearance of a rare and little-known disorder. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2004; 23:429-432. [PMID: 15055792 DOI: 10.7863/jum.2004.23.3.429] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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