Ovarian Tumour Presenting as an Inguinal Hernia in a Postmenopausal Woman with Mullerian Agenesis: A case report

Abstract

Although inguinal hernias are common with inguinal hernia repairs being a common surgical procedure, ovarian inguinal hernias are rare. A 67-year-old postmenopausal woman presented with a 10-year history of right inguinal swelling on a background of primary amenorrhoea. Clinical examination revealed a 10 cm right irreducible hernia. Ultrasound and computed tomographic imaging confirmed an ovarian mass in the inguinal hernia with absent uterus and right kidney in the pelvis. Mullerian agenesis with ovarian hernia was diagnosed, however malignancy was considered due to tumour size and raised cancer antigen 125 (CA125). She underwent diagnostic laparoscopy, bilateral salpingo-oopherectomy, partial omentectomy, and inguinal hernia repair. Histopathological reports confirmed ovarian fibroma. Ovarian hernia is rare in postmenopausal women but must be considered in those presenting with inguinal masses. It can occur together with Mullerian abnormalities. CA125 can be elevated in various benign conditions, making interpretation and diagnosis difficult. Multidisciplinary approach is vital to ensure the best outcome for the patient.