The necessity of routine histologic examination of hernia sac, revisited

Nemer, Areej M. Al; Al-Buainain, Hussah

doi:10.1007/s10029-014-1338-1

Cited by 8 publications

(2 citation statements)

References 15 publications

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“…Val-Bernal et al [2], on the other hand, recommends pathological examination of all hernia sacs without distinguishing them as inguinal or abdominal hernias, and microscopic examination only for those with macroscopic pathology. Nemer et al [28] recommended sampling only the sacs with patients older than 50 years of age, positive oncology history, or unusual gross findings. However, in the literature, it is remarkable that 22.2-73% of cases with malignancy in the hernia sac were not found to have gross pathology [1][2][3][4]9, 10] (Table 3).…”

Section: Discussionmentioning

confidence: 99%

Surprise in hernia sacs: Malignant tumor metastasis

Seçinti¹,

Gürsoy²,

Özgür³

et al. 2022

Journal of Surgery and Medicine

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Background/Aim: Malignant tumors are rare in the hernia sac, and there are very few studies on this subject in the literature. We aimed to investigate the malignancies in surgically resected hernia sacs and their clinicopathological features in the last ten years in our institution. Methods: The hernia sac specimens sent for pathological examination between 2010 and 2021 were included in this retrospective cohort study. The age and gender of the patient, the type of hernia and known malignancy history of all patients were recorded. Cases with malignancy in the hernia sac were selected and their slides were re-evaluated. The cases with and without malignancy in the hernia sac were compared in terms of age, gender and known cancer history. Results: There were 455 hernia sac specimens belonging to 448 patients which underwent pathological examination between 2011 and 2021. Malignancy was detected in ten (2.20%) hernia sacs. Eight were malignant tumor metastases (1.75%). The remaining two were secondary involvement of another malignancy. Five malignant tumors were ovarian serous carcinoma, one was vulvar squamous cell carcinoma, one was appendiceal mucinous cystadenocarcinoma, one was malignant melanoma metastasis, one was undifferentiated pleomorphic sarcoma, and one was non-Hodgkin lymphoma. The incidence of hernia sac malignancy was similar in male and female patients (3.5% and 1.4%, respectively; P=0.190). There was a known cancer history in 70% (n=7) of ten patients with malignancy in the hernia sac. The incidence of malignancy in the hernia sacs of patients with a known cancer history was significantly higher (P<0.001). Malignancies were present in 0.95% (n=2) of inguinal hernias, 1.67% (n=2) of abdominal hernias and 5.45 % (n=6) of incisional hernias. Gross pathology was detected in the macroscopic examination of all malignant inguinal hernias, but not in any of the abdominal hernias. Conclusion:We recommend the microscopic examination of hernia sacs, even if there is no macroscopic abnormality, especially in the elderly and/or patients with a history of malignancy, in order to detect incidental metastases.

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Section: Discussionmentioning

confidence: 99%

Surprise in hernia sacs: Malignant tumor metastasis

Seçinti¹,

Gürsoy²,

Özgür³

et al. 2022

Journal of Surgery and Medicine

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“…Since the vast majority of hernia sacs merely comprise peritoneum without findings that impact on future management of the patient, routine pathologic evaluation is generally found not to be necessary or cost effective. [101][102][103][104] However, in case of macroscopic unusual findings, sending the sack and resected material can be helpful. Some also advocate for sending the sack when vas deferens injury is suspected.…”

Section: Unusual Findings In the Hernia Sacmentioning

confidence: 99%

Femoral, Direct, and Rare Inguinal Hernias in Children—An Update

Gödeke

Muensterer

2017

Eur J Pediatr Surg

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Pediatric surgeons deal with inguinal hernias on a regular basis. While most of these are straightforward in terms of diagnosis and therapy, occasionally what initially sounds like a routine case turns out to be a perplexing conundrum. This review discusses rare and unusual findings in the groin area that may mimic an indirect inguinal hernia, but are not. To provide good and effective care, pediatric surgeons should be readily familiar with the possible differential diagnosis of these entities, along with their specific management. In general, laparoscopy is one of the most useful interventions to discern unusual groin pathology from standard indirect inguinal hernias and in many cases provides an effective treatment option at the same time.

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Does everything a surgeon takes out have to be seen by a pathologist? A review of the current pathology practice

2015

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Histopathologic examination of surgically removed tissues and organs is an important aspect of modern hospital quality health care. Most surgical specimens deserve to be submitted for pathologic examination, which may yield valuable new information relevant for the future treatment of the patient. A small number of specimens, recognized as providing limited or no valuable clinical data during pathologic examination, may be placed on the list of specimens "exempt from submission" or those that are labeled as "for gross examination only." Guidelines written by the committees of the national regulatory organizations provide general orientation on how to deal with various specimens, but the final decision on which type of specimen to eliminate and which ones to include for pathologic examination rests on local governing and advisory bodies of each institution. Particular lists of specimens exempt from pathologic examination are best generated through a consensus agreement of clinical and laboratory physicians. Even though there is general nationwide and even international consensus on which types of specimens deserve pathologic examination and which do not, there are still discussions about the necessity of some pathologic examinations.

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The necessity of routine histologic examination of hernia sac, revisited

Cited by 8 publications

References 15 publications

Surprise in hernia sacs: Malignant tumor metastasis

Surprise in hernia sacs: Malignant tumor metastasis

Femoral, Direct, and Rare Inguinal Hernias in Children—An Update

Does everything a surgeon takes out have to be seen by a pathologist? A review of the current pathology practice

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