Published online Sep 16, 2021. doi: 10.12998/wjcc.v9.i26.7850
Peer-review started: March 30, 2021
First decision: April 28, 2021
Revised: May 6, 2021
Accepted: August 4, 2021
Article in press: August 4, 2021
Published online: September 16, 2021
Processing time: 164 Days and 4.7 Hours
Primary omental tumors are uncommon, and omental fibromas account for 2% of these tumors. Due to the low incidence of omental fibromas and the limited relevant literature, it is challenging for clinicians to make an accurate diagnosis of this condition, especially before surgery.
A 30-year-old man was admitted to the hospital because of a left epididymal mass with vague discomfort for more than 1 mo. A physical examination was performed, and the findings showed that the epididymal mass may have entered the abdominal cavity. Pelvic computed tomography was performed in our hospital and revealed a left inguinal hernia with a mass in the hernial contents, and no masses were found in the left epididymis. A traditional inguinal hernia incision was made. Intraoperative hernia contents were found to be of the greater omentum, and a 2.5 cm-diameter mass was found at the distal end of the greater omentum. The scrotum and epididymis did not exhibit other masses. Then, the mass of the greater omentum was excised. Intraoperative frozen pathological examination suggested a spindle cell tumor. The postoperative pathological examination suggested that the mass was an omental angiofibroma. Postoperatively, the patient recovered well and was discharged. Outpatient re-examinations were performed at 1 mo and half a year after the operation and showed no obvious abnormalities.
Due to the low morbidity rate associated with and latent nature of omental tumors, these tumors are difficult to diagnose preoperatively; thorough medical history taking, detailed physical examinations, and necessary imaging auxiliary examinations can help clinicians diagnose and treat these cases.
Core Tip: Primary omental tumors are not common, and omental fibromas account for 2% of these tumors. No previous studies have reported an omental fibroma combined with indirect hernia showing an epididymal mass. This case reminds us of the importance of detailed medical history, strict physical examination, and necessary imaging examinations when clinicians dealing with similar cases.