Contents of inguinal hernial sacs may be protean. They can include almost any structure in the abdomen as well as benign and malignant lesions which afflict these structures. Also, metastatic foci to the peritoneal lining of the sac can result from remote and adjacent malignant processes. This paper is concerned only with neoplastic processes found primarily within a hernial sac.
In 1899 Lejars4 presented a classification of tumors of hernial sacs: intrasaccular, saccular, and extrasaccular. The microscopic pathological descriptions of representative cases were, for the most part, not complete. Nevertheless, adhering to this classification, Pagliani,6 in 1937, collected from the foreign literature four documented intrasaccular tumors: Nové and Josserand *—lipoma of appendix; Patel †—carcinoma of appendix; Gros and Denard ‡—fibrosarcoma of mesentery; Richard7—fibroma of mesentery. He also found a single case of saccular tumor (Rossi §—mesothelioma of sac) but no extrasaccular tumors. In addition, he presented
FIEBER SS, WOLSTENHOLME JT. Primary Tumors in Inguinal Hernial Sacs. AMA Arch Surg. 1955;71(2):254-256. doi:10.1001/archsurg.1955.01270140102018