Laparoscopic approach to inguinal hernia with incarcerated ovary in a patient with endometrial neoplasia

Alba María Serrano Molina, Carmen Gutiérrez Sánchez, Omar Carreño-Saénz, Salvador Pous-Serrano
In: BMJ Case Reports · 2025 · vol. 18(2) , pp. e263421 · doi:10.1136/bcr-2024-263421 · PMID:40000041 · W4407934437
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Abstract

Ovarian inguinal herniation is a rare clinical entity. It can be safely managed laparoscopically, even in patients with concurrent gynaecological malignancies requiring radical hysterectomy.We present the case of a middle-aged woman admitted for severe anaemia and progressive weakness. Imaging revealed endometrial cancer and a right inguinal hernia containing an 8 cm lesion of indeterminate origin. MRI identified strangulated ovarian tissue within the hernia, and histopathology confirmed a low-grade endometrioid adenocarcinoma.The patient underwent a planned laparoscopic procedure, including radical hysterectomy, sentinel lymph node biopsy and simultaneous inguinal hernia repair. The hernia was repaired using the transabdominal preperitoneal approach after excision of the right adnexa, with polyvinylidene fluoride mesh fixation. The patient experienced an uneventful recovery and was discharged on the second postoperative day.Histopathological analysis confirmed low-grade endometrioid carcinoma with clear margins and metastasis in two lymph nodes, demonstrating the feasibility of managing both conditions concurrently.

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