MUCIN DEPOSITS WITHIN INGUINAL-HERNIA SACS - A PRESENTING FINDING OF LOW-GRADE MUCINOUS CYSTIC TUMORS OF THE APPENDIX - A REPORT OF 2 CASESAND A REVIEW OF THE LITERATURE

Two male patients, both 41 years of age, presented clinically with a t ypical inguinal hernia. The herniorrhaphy specimens were found on rout ine pathologic examination to contain abundant mucin that was focally organizing and was devoid of associated epithelial cells, Both cases w ere seen in consultation because of uncertainty as to the nature of th e process. The possibility that the mucin might represent spread from an appendiceal mucinous cystic tumor led to the investigation of the a ppendix and in both cases such a tumor was discovered, The widespread involvement of the peritoneum that is characteristic of pseudomyxoma p eritonei was absent in each case. These cases represent one of the mar ry ''surprise'' findings that may be encountered in hernia sac specime ns and one of the many problematic pathologic manifestations that may be associated with low-grade mucinous neoplasms of the appendix. Altho ugh this phenomenon is described in the literature, experience with ou r two cases indicates that it may still pose a significant diagnostic challenge.