Herniation of the bladder into the inguinal canal (bladder ear) is rare and occurs in 1% to 3% of all inguinal hernias. It is commonly seen in infants but rarely observed in adults. Most bladder hernias are asymptomatic but may be discovered unexpectedly during herniorrhaphy or with an occasional intraoperative bladder injury because of partial or near-total cystectomy of the bladder ear in a herniated sac. The appearance of bladder ear hernias on voiding cystourethrography, intravenous pyelography, and CT has been well described. Bladder activity is frequently seen in general nuclear medicine studies with significant bladder activity such as bone scans, renal scans, and PET/CT studies. The finding on PET/CT is what would be expected based on prior CT and IVP results, and in the current case, where such activity could be mistaken for malignancy, such recognition becomes even more important. Restaging PET/CT images of a patient with a history of head and neck cancer revealed a focal intense metabolic activity in the left inguinal canal. Without the CT information, such focal activity could be mistaken for metastatic nodal disease. Intense physiologic metabolic activity in cancer patients may represent potential pitfalls in the interpretation of PET/CT studies. Familiarity with the appearance of bladder ears on PET/CT may facilitate appropriate diagnosis and avoid false interpretation.
- Bladder ear
- Bladder hernia
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging