Gastrointestinal stromal tumor (GIST) presenting as a groin mass mimicking and incarcerated hernia

INTRODUCTION: The contents of a hernial sac can harbor preperitoneal fat, epiploon or some hollow viscera, with a malignant lesion in its interior being an unusual finding. PRESENTATION OF CASE: We present the case of a 59 year-old male who arrived in the Emergency Department with an irreducible inguinal hernia, with no local signs of vascular compromise. The diagnosis was made after examining the hernia sac, using an inguinal approach, showing evidence of a largely necrosed gelatinous mass, which was resected by mid-line infraumbilical laparotomy. The mass was diagnosed as a high risk gastrointestinal stromal tumor. DISCUSSION: GIST are characterized by the absence of symptoms in most cases. The unusual presentation, as incarcerated hernia, allowed the diagnosis of this disease. The tumor measured 6 cm with a mitotic index greater than 5/50 CGA tumor is classified as high risk. The finding of a thickened peritoneum proceeded to opening. The exploration of the sac is critical. CONCLUSIONS: Exploring the hernia sac in any complicated hernia, especially when the sac has macroscopic alterations and presence of areas of bleeding inside is essential.