Clin Surg | Volume 7, Issue 1 | Case Report | Open Access

Spermatic Cord Cyst Presenting as an Inguinal Hernia Discovered Intraoperatively during Planned Open Herniorrhaphy: A Case Report

Logan D Glosser1*, Wade Hopper2, Hanna M Knauss1, Motaz Al-Yafi3 and Arun Baskara3

1University of Toledo College of Medicine and Life Sciences, USA
2Edward Via College of Osteopathic Medicine, USA
3Department of General Surgery, University of Toledo College of Medicine, USA

*Correspondance to: Logan D Glosser 

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Abstract

Background: Benign swelling of the inguino-scrotal region is most commonly caused by inguinal hernias, although other etiologies exist. In most cases, diagnosis is made by history and physical exam alone. However, without imaging or further studies, other occult etiologies cannot be excluded. Rarely, spermatic cord cysts present with symptoms mimicking inguinal hernia. Case Report: We report the case of a middle-aged male with a one-year history of a bulge in the left inguinal area that presented after heavy lifting. The patient complained of intermittent pain and enlargement since initial presentation. On physical exam, an irreducible mass in the left inguinal area was palpated. The patient was diagnosed with an inguinal hernia and underwent surgery for open repair with mesh. Perioperative discovery of a cyst attached to the spermatic cord was identified that trans-illuminated without evidence of a hernia. The cyst was excised. Final pathology showed a benign cyst with surrounding chronic inflammation, fibrosis, and soft tissue reactive changes. Spermatic cord cysts should be recognized in the differential diagnosis of inguinal bulge, with consideration of sonographic assistance to differentiate from hernia. Clinical Discussion: Few cases have reported spermatic cord cysts found during intraoperative repair of a clinically diagnosed inguinal hernia. This case highlights the need for surgeons to develop a broad differential diagnosis in cases of suspected inguinal hernia, with consideration of preoperative diagnostic imaging. Conclusion: Currently, patients with a history and physical exam suspicious for inguinal hernia are not recommended to undergo preoperative imaging. Our case calls into question whether preoperative imaging with ultrasound or computed tomography should be included in routine preoperative evaluation. We present a case of a spermatic cord cyst that was misdiagnosed preoperatively as an indirect inguinal hernia resulting in prolonged surgery.

Citation:

Glosser LD, Hopper W, Knauss HM, Al-Yafi M, Baskara A. Spermatic Cord Cyst Presenting as an Inguinal Hernia Discovered Intraoperatively during Planned Open Herniorrhaphy: A Case Report. Clin Surg. 2022; 7: 3517..

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