Spigelian hernia: An unusual cause of an elevated CA-125

Spigelian hernias are spontaneous lateral ventral abdominal wall hernias occurring along the subumbilical portion of the semilunar line of Spigel and through the spigelian fascia. It is an uncommon hernia with a variety of presentations that usually remains undiagnosed until exploratory laparotomy. We report a 62-year-old woman with an elevated CA-125 value of 149 and intraoperative findings of a left spigelian hernia. A simple herniorrhaphy was performed, and she is without evidence of recurrence of the hernia after 9 months of follow-up. The CA-125 value returned to normal levels. Spigelian hernias are rarely suspected but, when encountered, should be repaired. A review of the anatomic features and management of this unusual defect is given.