模仿腹股溝疝氣的侵襲性血管淋巴瘤 : 一個罕見的案例報告

曾博鴻、林介山

彰化基督教醫院 外科部 泌尿科

Aggressive angiomyxoma mimicking inguinal hernia: a rare case report

Po-Hung Tseng, Jesun Lin

Divisions of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan

Introduction

Aggressive angiomyxoma is a rare mesenchymal tumor in adults. Most of current cases were reported in genitalia, perineum and pelvic region of female. Common sites of aggressive angiomyxoma in male were found in inguinoscrotal, para-testicular and perineal region. Because of its rarity it was usually misdiagnosed as hernia, hydrocele or lymph node in inguinal region. It could cause recurrence because of incomplete resection of tumor.

Case report

The patient is a 33-year-old man who complained of a protruding mass over right inguinal area accompanied with intermittent abdominal cramping pain for several months. He denied any past history, recent medicine use and trauma history. Due to progressed symptoms, he went to Urology outpatient department for further evaluation. Physical examination revealed a soft, movable mass without tenderness. Under the impression of right inguinal hernia, he agreed with surgical treatment. Hydrocele and spermatic varicocele with a tumor were found during operation incidentally and sent for pathology. After surgery, pain control and anti-inflammation drug was given, The post-operation course is smooth. Final pathology report revealed aggressive angiomyxoma.

Conclusion

Although prognosis of aggressive angiomyxoma is good. Higher recurrence rate due to misdiagnosis related incomplete excision of tumor is still a problem. Accurate diagnosis preoperatively and wide resection with free margin during operation are necessary to prevent recurrence.