Bladder hernia simulating metastatic lesion on FDG PET study

A 67-year-old man with a cerebral metastasis underwent an FDG PET study to search for the primary tumor. Colonic adenocarcinoma without liver metastases was found. An unsuspected inguinal focus, simulating a metastasis, was urinary activity in a vesical hernia. Vesical hernias are not so uncommon, accounting for 0.4-3% of all inguinal hernias, but massive bladder hernias at the inguinoscrotal level are rare. They affect mainly men older than 50 years and may be responsible for misdiagnosis when radiopharmaceuticals with main urinary excretion are used.