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Arch Surg. 1940;41(5):1215-1219. doi:10.1001/archsurg.1940.01210050175009.
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The sacs of inguinal hernias have been known to contain almost every type of normal and diseased abdominal viscus. Malignant tumors of organs contained in the sacs have been described, and, less frequently, secondary involvement of the tissues of the sac by extension or metastasis has been noted. Primary malignant tumors of the tissues of hernial sacs, however, are extremely infrequent. Baretz1 reported an adenocarcinoma of a hernial sac, but it is obvious that a tumor of this type could not have arisen primarily from any but an epithelial structure and could not, therefore, have been primary in the sac. Unfortunately, postmortem examination was not done. Pagliani2 reported a benign tumor, a fibromyxoma, which was primarily in the sac and which had been diagnosed preoperatively as a strangulated hernia. The only case encountered in the literature of the past two decades of primary malignant tumor of the sac


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