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Amyand's hernia, defined as the presence of the vermiform appendix within an inguinal hernia sac, is an uncommon surgical finding. The association with appendiceal neoplasms is exceedingly rare, particularly in the absence of inflammatory signs. We report the case of a 71-year-old male with a longstanding right inguinoscrotal hernia presenting with progressive discomfort. An open hernia repair revealed the cecum and a macroscopically non-inflamed appendix within the hernia sac. Appendectomy was performed, followed by sutureless mesh hernioplasty. Histopathological examination unexpectedly demonstrated a low-grade appendiceal mucinous neoplasm with free resection margins. The postoperative course was uneventful, the patient remained asymptomatic at follow-up. This case suggests that even a clinically silent appendix within an Amyand's hernia may harbor occult neoplastic pathology. Appendectomy should therefore be considered in adult patients to avoid missed diagnoses with potential oncological implications.