A rare case report of inverse sciatic hernia unveiling as a lipoma

Abstract

When a swelling arising in the gluteal region herniates into the pelvic cavity through the sciatic foramen, it is referred to as inverse or reverse sciatic hernia and is a rare occurrence. We present the case of a 62-year-old female who presented with swelling in the left gluteal region with features of sciatica and abdominal pain. Magnetic resonance imaging showed 27 cm × 22 cm × 9cm soft tissue swelling arising from the gluteal region and inversely herniating into the pelvic cavity through the sciatic foramen. We were successful in delivering the tumor through a gluteal approach. Lipomatous tumors presenting as inverse sciatic hernia are a rare event.

Keywords

Gluteal lipoma / lipoma / lipomatous tumor / reverse sciatic hernia / sciatic hernia

References

[1] Gomez-Seoane A , Oyasiji T . Gluteal liposarcoma presenting as sciatic hernia: A case report and review of literature. Int J Surg Case Rep 2020; 67: 25- 9.

[2] Kerry RL , Tygart RL , Glas WW . Lipoma: A “reversed” perineal sciatic hernia. Am J Surg 1964; 107: 883- 4.

[3] López-Tomassetti Fernández EM , Hernández JRH , Esparragon JC , García AT , Jorge VN . Intermuscular lipoma of the gluteus muscles compressing the sciatic nerve: An inverted sciatic hernia. J Neurosurg 2012; 117: 795- 9.

[4] Dulskas A , Poskus E , Jurevicius S , Strupas K . Giant gluteal lipoma presenting as a sciatic hernia. Hernia 2015; 19: 857- 60.

[5] Losanoff JE , Basson MD , Gruber SA , Weaver DW . Sciatic hernia: A comprehensive review of the world literature (1900-2008). Am J Surg 2010; 199: 52- 9.

[6] Kaur N , Kaur N , Chhabra HS , Singh M , Singh P . A case report of sciatic hernia as a cause of sciatica and lower back pain: Diagnostic dilemma for family physicians. J Family Med Prim Care 2022; 11: 3304- 7.

[7] Ghahremani GG , Michael AS . Sciatic hernia with incarcerated ileum: CT and radiographic diagnosis. Gastrointest Radiol 1991; 16: 120- 2.

[8] McTighe S , Chernev I . Intramuscular lipoma: A review of the literature. Orthop Rev (Pavia) 2014; 6: 5618.

[9] Kransdorf MJ , Bancroft LW , Peterson JJ , Murphey MD , Foster WC , Temple HT . Imaging of fatty tumors: Distinction of lipoma and well-differentiated liposarcoma. Radiology 2002; 224: 99- 104.

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International Journal of Abdominal Wall and Hernia Surgery | Published by Wolters Kluwer - Medknow on behalf of Higher Education Press