Publication:

Colorectal adenocarcinoma infiltrating inguinal hernia mesh: a case report and systematic review

Inguinal hernia repairs are standard procedures globally, but while reducing recurrence, they can introduce complications such as infection, migration, and bowel obstruction. The extent of prosthetic mesh involvement in synchronous malignancies, particularly regarding cancer seeding or direct invasion, remains underexplored. This case report highlights an uncommon presentation of colorectal adenocarcinoma, initially manifesting as a mesh-related complication, in a 74-year-old male with a history of two previous right inguinal hernia repairs. Initial evaluations, including colonoscopy and carcinoembryonic antigen levels, offered no indication of cancer. However, subsequent investigation led to robotic adhesiolysis, preperitoneal debridement, and mesh explantation, definitively revealing metastatic moderately differentiated adenocarcinoma on the mesh, strongly suggesting a colorectal primary neoplasia. Despite multiple interventions and chemotherapy, the patient developed progressive metastasis. We identified only 8 reported cases describing mesh invasion or complications due to various primary tumors presenting as inguinal masses, pain, or swelling, making this an extremely rare complication. Surgical management in these cases primarily involved tumor resection and mesh removal, with mixed outcomes. This case therefore underscores the rare but significant occurrence of metastatic colorectal adenocarcinoma seeding prosthetic mesh following inguinal hernia repair.