The Inguinal Canal: Anatomy and Imaging Features of Common and Uncommon Masses

Movie 1. Lymphoproliferative disorder in 70-year-old man. Contrast enhanced axial CT scans show herniated bladder in the right inguinal canal.

Movie 2. Squamous cell cancer of the anus in 73-year-old man. Contrast-enhanced axial CT scans show inguinal canal hernia containing appendix.

Movie 3. Adenocarcinoma of the rectum in 66-year-old man. Contrast-enhanced axial CT scans show contrast opacified small bowel loops in the left inguinal canal.

Movie 4. Hepatocellular carcinoma in 55-year-old man. Contrast-enhanced axial CT scans show herniation of colon, cecum, and appendix into the right inguinal canal.

Movie 5. Lymphoma in 55-year-old woman. Contrast-enhanced axial CT scans show bilateral herniation of the ovaries into the inguinal canal.

Movie 6a. Colon cancer in 65-year-old man. Coronal T1-weighted MR images of the pelvis show a low-signal-intensity "mass" (arrow) in the inguinal canal representing the left testicle.

Movie 6b. Same patient as in Movie 6a. Contrast-enhanced axial T2-weighted MR images of the pelvis show a high-signal-intensity "mass" in the inguinal canal, representing the left testicle.

Movie 7. Sixty-four-year-old man with history of prostate carcinoma. Axial T2-weighted MR images show a mass with the signal intensity of fat in the left inguinal canal lateral to the spermatic cord (first arrow), representing a lipoma (second arrow).

Movie 8. Rectal adenocarcinoma in 66-year-old man. Axial gadolinium-enhanced T1-weighted MR images show peripheral enhancement of the fluid collection anterior to the urinary bladder extending into the left inguinal canal, representing an abscess.

Movie 9. Forty-six-year-old man with history of neurofibromatosis. Axial CT scans show plexiform neurofibromas of the left hemipelvis extending into the inguinal region and involving the ilioinguinal nerve.

Movie 10. Thirty-five-year-old man with right extra-adrenal paraganglioma causing obstruction of the right gonadal vein. CT scans of the pelvis show an enhancing serpiginous mass in the right inguinal canal, representing a right-sided varicocele resulting from compression of the renal vein by a right paraganglioma. Follow the right gonadal vein (arrow) into the right inguinal canal.

Movie 11. Colon cancer with perforation of the bowel in 57-year-old man. Axial CT scans of the pelvis show air in the left inguinal canal (arrow) due to perforated sigmoid diverticula.

Movie 12. Perforated gastric ulcer in 56-year-old man. Axial CT scans show extravasation of oral contrast medium from the peritoneum into the left inguinal canal (arrow).

Movie 13. Lymphoma in 54-year-old man. Axial CT scans through the pelvis show a fluid-attenuation mass (arrow) in the inguinal canal with no communication with the peritoneum or tunica vaginalis, representing an encysted hydrocele.

Movie 14. Melanoma in 52-year-old man. Axial CT scans of the pelvis show a right funicular hydrocele that communicates with the peritoneum at the internal ring.

Movie 15. Seventy-four-year-old man with history of erectile dysfunction. Axial CT scans of the pelvis show penile prosthesis, with the reservoir tubing (projecting over right iliac wing) traversing the inguinal canal. The piece of tubing in the inguinal canal connects the reservoir to the scrotal pump, and separate tubing connects the reservoir to the penile implant. To achieve erection, the patient squeezes the pump, which causes a flow of saline to the reservoir. The reservoir then allows saline to flow into the penile cylinders.

Movie 16. Liposarcoma in 56-year-old man. Axial CT scans of the pelvis with intravenous contrast medium show a fat-attenuation mass containing thin soft-tissue attenuation septations with a dense calcification.

Movie 17. Burkitt lymphoma in 17-year-old boy. Contrast-enhanced axial CT scans of the pelvis show enhancing infiltrative soft-tissue masses in both inguinal canals.

Movie 18. Unclassified sarcoma in 54-year-old man. Axial contrast-enhanced CT scans of the pelvis demonstrate heterogeneously enhancing soft-tissue mass in the left hemipelvis (first arrow) infiltrating into the left spermatic cord (second arrow) and testicle.

Movie 19. Alveolar rhabdomyosarcoma in 12-year-old boy. Axial CT scans of the pelvis after administration of intravenous contrast medium show a metastatic enhancing infiltrating mass involving the inguinal ligament (arrow) and extending into the inguinal canal. It should be noted that tumor is also seen in the left inguinal canal.

Movie 20. Appendiceal adenocarcinoma in 61-year-old man. Contrast-enhanced axial CT scans of the pelvis show a low-attenuation mass in the right inguinal canal contiguous with the peritoneal deposit (arrow indicates the inferior epigastric artery).

Movie 21. Prostate carcinoma in 64-year-old man. Contrast-enhanced axial CT scans show implants in the pelvis anterior to the bladder, wall thickening of the bladder due to radiation cystitis, and a metastasis extending to involve the right spermatic cord.

Movie 22. Forty-six-year-old man with history of metastatic carcinoid. Contrast-enhanced axial CT scans of the pelvis show a large heterogeneously enhancing mass in the left inguinal canal (second arrow), lateral to the inferior epigastric vessels (first arrow), inferior to the herniated colonic loop, and medial to inguinal adenopathy.

Movie 23. Metastatic melanoma in 47-year-old man. Contrast-enhanced axial CT scans of the pelvis show an enhancing mass (arrows) in the right inguinal canal, involving the spermatic cord.

Movie 24. Pancreatic adenocarcinoma in 66-year-old woman. Contrast-enhanced axial CT scans of the pelvis show an enhancing metastasis from pancreatic cancer in the right inguinal canal.

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