GS03 - A rare case of spermatic lymphangioma found in open inguinal hernia repair of an adult patient

Primary Presenter(s)

Judy Wong, MD

General Surgery resident
St John's Episcopal Hospital
St John's Episcopal Hospital
Far Rockaway, New York, United States

Researcher(s)

DK

Dmitry Kim, D.O.

Attending
St. John episcopal hospital
Far rockaway, New York, United States

Introduction/Purpose: Lymphangiomas are congenital malformation of lymphaticovenous sacs commonly found in infants and children; approximately 65% appear at birth and 90% by the age of two. Most commonly lymphangiomas are found in the neck, but 5% can develop from the urogenital system. However, in this rare case it was found in an adult patient.

Methods or Case Description: This is a 62 year old male, PMH CHF, CAD, HTN, CKD, COPD, DM, with chronic large right scrotal hernia who presented with worsening right groin pain. Patient has been able to reduce it himself over the past year, however has been unable to reduce it for one day. Patient was found to have an incarcerated right scrotal hernia and was taken emergently for open right inguinal hernia repair with mesh. The hernia sac was opened and explored. The patient was found to have a sliding hernia containing viable cecum. The hernia sac was suture ligated and a large mesh plug was placed into internal inguinal ring and progrip mesh was placed. On pathology review of hernia sac and content, patient found to have spermatocele and lymphangioma. Patient tolerated procedure and was discharged, but was lost to follow up.

Outcomes: On literature search on spermatic cord lymphangioma over the past 20 years on PUBMED, only five case reports of spermatic cord lymphangiomas were found. Of the five case reports, only one case report was seen to have spermatic cord lymphangioma in an adult patient. Spermatic lymphangioma is a benign tumor and sclerotherapy or resection is the treatment. However, patients are usually followed postoperatively to see if symptomatic swelling develops and is assessed for possible recurrence which may require orchiectomy.

Conclusion: This case report is to contribute literature for rare finding of spermatic cord lymphangioma in adults.