Lipomas are considered one of the most frequent benign mesenchymal tumors with copious variants. Among these variants is angiomyxolipoma (AML) which is considered an extremely rare entity. To the best of our knowledge, only 19 cases have been reported in the English medical literature, of which three of them involving the spermatic cord. Herein, we report the fourth case of a 37-year-old male patient with angiomyxolipoma (AML) of the spermatic cord discovered incidentally during elective hernia repair.

A 28-year-old male was referred to our radiology department with the complaint of inguinal mass. He had this mass since its childhood but has recent discomfort. First of all ultrasound was performed and it showed tubular structures connecting with each other. Doppler Ultrasound showed no flow within the tubular mass. At first a thrombosed vascular malformation or lymphocele was considered in differential diagnosis. A scrotal MRI (magnetic resonance imaging) was requested by urology department for further characterization. No right seminal vesicle was seen in its anatomical position and left seminal vesicle is seen in the normal location on MRI (Panel A, axial T2 weighted image; Panel B, coronal T2 weighted image, arrow). There was a tubular cystic mass in right inguinal canal with the same intensity as left seminal vesicle on all sequences (Panel C, Axial T2 weighted image; Panel D, coronal T2 weighted image, arrow). The diagnosis of ectopic seminal vesicle was made. To the best of our knowledge there was no case in literature with an ectopic seminal vesicle. It can be a rare cause of inguinal mass and should be kept in differential diagnosis.

We present the case of a 12-month-old male diagnosed with an extrarenal Wilms tumor found incidentally at the time of inguinal orchiopexy. He was staged and treated according to Children\'s Oncology Group (COG) protocol, with no evidence for disease at the end of treatment. We review the patient\'s presentation and treatment course, followed by a review of current literature on extrarenal Wilms tumor and considerations for management.

Canal of Nuck abnormality is a rare surgical condition. The pathologies are mostly encountered in young girls, less than five years of age. The incidence is even less in adults. Various pathologic conditions related to the failure of processus vaginalis obliteration can occur, involving herniation of intraabdominal structures including intestinal and genital contents such as the uterus, fallopian tube, and ovary and hydrocele of the canal of Nuck. According to its rarity, hydrocele of canal of Nuck is often misdiagnosed for common groin masses. This review summarizes and simplifies embryology, the pathophysiology of the canal of Nuck abnormalities, imaging findings, and treatment options with emphasis on the hydrocele.

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Adenocarcinoma of the lung can present with distant metastasis, with major metastasis sites being mediastinal lymph nodes, liver, brain, and adrenal glands. Inguinal lymph nodes are an unusual site for distant metastasis of adenocarcinoma of the lung. We discuss the case of a 73-year-old Caucasian female with a medical history significant for hypertension, chronic obstructive pulmonary disease (COPD) who was seen in the primary care clinic for ongoing shortness of breath, worsening cough, and wheezing. She was prescribed a short course of steroids and antibiotics for possible COPD exacerbation. Despite these measures, the patient had worsening pulmonary symptoms and got evaluated in the emergency room. A CT scan of the chest showed right upper lobe bilobed masses and bulky mediastinal lymph nodes resulting in the partial collapse of the lung\'s right upper lobe. She got admitted to the hospital for further evaluation, and pulmonary service was consulted for possible endobronchial ultrasound-guided biopsy (EBUS) of the mediastinal nodes. During the physical exam, she was found to have a large fungating mass in the right groin. Upon further questioning, she reported that the mass began as a small swelling in the groin three months ago and was evaluated by the primary care physician and received antibiotics for two weeks. During this time, she did not have any worsening pulmonary symptoms. She underwent bedside excisional biopsy of the lymph node; the pathology came back positive for metastatic adenocarcinoma of pulmonary origin. Unfortunately, the patient had a significant worsening of her respiratory distress; she transitioned to comfort measures and passed away three days later. In this article, we report a case of metastatic lung adenocarcinoma with the inguinal lymph nodes\' involvement as the site of distant metastasis, followed by a brief review of the occurrence of adenocarcinoma with the inguinal lymph nodes\' involvement.

BACKGROUND: Malignant peritoneal mesothelioma is an unusual disease process characterized radiologically by ascites and infiltration of the peritoneum by multiple small tumor nodules. Both parietal and visceral peritoneum are involved by the multiple malignant tumor nodules. Computed tomography (CT) has been used to identify the anatomic pathology induced by the progression of this malignant process.
OBJECTIVE: To identify and then describe unusual CT images in patients with malignant peritoneal mesothelioma. Recognition of these unusual radiologic findings can cause the radiologist to be suspicious of this rare malignant process.
METHODS: In 100 patients who were to undergo definitive treatment of malignant peritoneal mesothelioma, the findings on preoperative CT scans were catalogued. Many of these changes were repeatedly noted on the CT scans. Other pathologic CT images were less common. These unusual radiologic presentations were specially studied in this manuscript.
RESULTS: Eight unusual radiologic presentations of malignant peritoneal mesothelioma were selected for study. These unusual findings included a mass occurring within a Spigelian hernia, infiltration of the splenic parenchyma by spherical mesothelioma masses, infiltration of the lower mediastinum by tumor, a mesothelioma mass within a left inguinal canal, enlarged cardiophrenic angle lymph nodes, pleural plaques associated with the progression of malignant peritoneal mesothelioma, splenic notches caused by disease surrounding the spleen, and a mass greater than 5 cm associated with the proximal jejunum and directly adjacent to the anatomic location of the Treitz ligament.
CONCLUSIONS: There are unusual radiologic presentations of malignant peritoneal mesothelioma that are important to recognize in order to accurately diagnose this disease by CT.

BACKGROUND: Ovarian cancer has few subjective symptoms, so approximately 40%-50% of cases have already reached stage III or IV by the time of diagnosis. These are advanced stages of the disease and have poor prognosis. Among these cases, less than 3 % are reported to exhibit inguinal lymph node metastasis. This report documents a rare case of advanced ovarian cancer that we detected due to an inguinal metastasis in the canal of Nuck. The work has been reported in line with the SCARE criteria.
METHODS: The patient was a 43-year-old, married, premenopausal woman (G2P1). She was examined by her local practitioner for a chief complaint of a mass in the right inguinal region and was found to have a right inguinal mass. Magnetic resonance imaging (MRI) scans revealed a left ovarian tumor, and she was referred to our department. Rapid intraoperative diagnosis showed a highly atypical serous carcinoma present in both the left ovary and the right inguinal region mass, where the tumor had extended into the canal of Nuck.
CONCLUSIONS: In this case, the right inguinal mass was ovarian cancer that had metastasized to a cyst in the canal of Nuck via the round ligament of the uterus. Though, many adult women with these types of inguinal hydrocoeles sometimes undergo fine-needle aspiration.
CONCLUSIONS: This finding may highlight the need for a careful search for metastasis to the inguinal region in cases of ovarian cancer.

UNASSIGNED: Angiomyofibroblastoma is a rare benign myofibroblastic neoplasm which mainly occurs in the soft tissues of the pelvi-perineal region of females.
UNASSIGNED: To present an unusual case of angiomyofibroblastoma mimicking an inguinal hernia in a 62-year-old male.
UNASSIGNED: The patient was hospitalized with an irreducible, painless inguinal mass and surgical intervention for inguinal hernia was decided. The well-defined nodular mass was sent for histological examination.
UNASSIGNED: Under microscope, proliferation of spindle and oval cells around thin-walled vessels was observed, being intermingled with mature adipocytes. We did not identify necrosis, haemorrhage, cytologic atypia or mitotic figures. The tumour cells displayed positivity for desmin, vimentin, CD34, oestrogen and progesterone receptors, a low Ki67 index and unusual nuclear positivity for c-theta (PKCθ). They were negative for smooth muscle actin (SMA), S100, CD44, maspin, synaptophysin, DOG1 and CD117. The case was diagnosed as angiomyofibroblastoma, the main challenge being the differential diagnosis with aggressive angiomyxoma, which can present a similar histologic aspect and immunophenotype and recurs more frequently. No recurrences were observed 8 months after the surgery.
UNASSIGNED: Angiomyofibroblastoma should be included in the differential diagnosis of inguinal hernia. This is the fourteenth case of angiomyofibroblastoma diagnosed in males.

Aneurysm of the testicular artery is a rare entity; the term is described as the dilation of any blood vessel in the body.
An 18-year-old patient with a left testicular artery aneurysm, with no family or personal history of medical importance, presented for consultation due to a volume increase of long evolution in the inguinal region, accompanied by sporadic pain with no other symptoms. The testicular artery aneurysm was not detectable preoperatively by ultrasound, which only reported data compatible with left inguinal hernia and varicocele. The diagnosis was made postoperatively by a histopathological study. This case highlights the presentation of a true aneurysm of the testicular artery and the result after definitive surgical treatment.
The etiology of the aneurysm and pseudoaneurysm reported in the literature is described after a testicular trauma and, a few cases of congenital origin. The clinical manifestations are pain and an inguinal mass, which can be frequently confused with inguinal hernias or an aggregated pathology. Therefore, the approach of patients with inguinal or testicular pathology should be protocolized and include aneurysm within the differential diagnoses.
El aneurisma de la arteria testicular es poco frecuente; el término se describe como la dilatación de cualquier vaso sanguíneo en el cuerpo.
Se presenta el caso de un paciente de 15 años con un aneurisma de la arteria testicular izquierda sin ningún antecedente de importancia familiar ni personal, quien se presentó a consulta por aumento de volumen en la región inguinal de larga evolución, acompañado de dolor esporádico y sin más síntomas. Se diagnosticó hernia inguinal y se procedió a cirugía. El diagnóstico se realizó de manera posoperatoria por medio de estudio histopatológico. En este caso, se destaca la presentación de un aneurisma verdadero de la arteria testicular y el resultado después del tratamiento quirúrgico definitivo.
La etiología del aneurisma y del pseudoaneurisma reportada en la literatura se describe posterior a un traumatismo testicular, y en pocos casos de origen congénito. Las manifestaciones clínicas pueden ser dolor y una masa inguinal, y muchas de las veces pueden confundirse con hernias inguinales o ser una patología agregada, por lo que el abordaje de los pacientes con patología inguinal o testicular debe ser protocolizado e incluir el aneurisma dentro de los diagnósticos diferenciales.