Ovary herniating into rectus sheath

Case contributed by Morouj Shaggah
Diagnosis certain

Presentation

Palpable painless right abdominal mass. History of hysterectomy.

Patient Data

Age: 45 years
Gender: Female

A thick-walled fluid-filled structure is seen herniating into the right rectus muscle with a small neck and a connected tubular structure that has no intraluminal gas and seems to reach the IVC, contrast administration is advised for better characterization.

In surgery

Photo

According to the surgeon, the mass appears cystic in nature with a small cavity that contains a hematoma.

Case Discussion

A contrasted study was advised, but the decision was made to go for surgery.

Histopathology report:

Macroscopic description:
The specimen consists of 10 gm, 6.5x3x1.5 cm grey-white soft tissue piece.  

Microscopic description:

Sections reveal ovarian tissue with corpus luteum as well as unremarkable vascularized fibrofatty tissue. No malignancy seen in the examined levels. 

Diagnosis: Right abdominal wall hernia, content: unremarkable ovarian tissue.

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