Endometriosis of the Inguinal Canal Mimicking a Hydrocele of the Canal of Nuck

Basnayake, Oshan; Jayarajah, Umesh; Seneviratne, Sanjeewa

doi:10.1155/2020/8849317

Cited by 6 publications

(11 citation statements)

References 15 publications

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“…We performed an extensive review of the English literature using the search terms “inguinal endometriosis”, “groin endometriosis” and/or “extra-pelvic endometriosis” in the title, abstract, and/or keywords of articles indexed in the Medline, Scopus, and Google Scholar databases, which is summarized in Table 1 . Only 29 cases of inguinal endometriosis have been reported in nulliparous women similar to our case [ 3 – 49 ].…”

Section: Discussionsupporting

confidence: 79%

“…It typically involves intra-pelvic organs and peritoneum, but can also affect any extra-pelvic organs [ 2 ]. It commonly occurs after implantation of endometrial tissue during previous pelvic surgical procedures [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Its incidence is not estimated, as there are only around 50 cases reported in the literature. It represents a diagnostic dilemma as it is often misdiagnosed as other inguinal pathologies such as inguinal hernia, soft tissue tumors, and inguinal lymphadenopathy [ 3 – 5 ]. Most of the reported cases are managed surgically without preoperative imaging or biopsy [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Inguinal Endometriosis in a Nulliparous Woman Mimicking an Inguinal Hernia: A Case Report with Literature Review

et al. 2021

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Patient: Female, 33-year-old Final Diagnosis: Inguinal endometriosis Symptoms: Groin pain Medication: — Clinical Procedure: Exploration of inguinal canal Specialty: Surgery Objective: Rare disease Background: Endometriosis is a common gynecological disorder occurring in around 10% of women of reproductive age. Inguinal endometriosis is a rare condition; however, it should be considered in the differential for inguinal masses in women of reproductive age. Usually, it occurs after implantation of endometrial tissue during previous surgical procedures. Patients with inguinal endometriosis are often multiparous women with a history of previous gynecological or obstetric surgery. It represents a diagnostic dilemma, as it is often misdiagnosed as other inguinal pathologies. Case Report: Herein, we report a case of a 33-year-old nulliparous woman with left groin pain for 2 years increasing in the severity during menstruation. A physical examination revealed a 1.5-cm left inguinal mass. Ultrasound showed an ill-defined speculated solid hypoechoic left inguinal mass measuring 1.6×1.4 cm. Computed tomography (CT) of the pelvis revealed a left inguinal mass measuring 1.7×1.2 cm, demonstrating central hypo-attenuation with thickening of the round ligament. Exploration of the inguinal region revealed an adherent mass to the round ligament and floor of the canal, which was excised completely with a safety margin. The inguinal canal floor was strengthened using proline mesh. Histopathological examination of the mass confirmed the diagnosis of left inguinal endometriosis. Conclusions: Inguinal endometriosis is a rare clinical entity mimicking other common inguinal conditions. A high index of suspicion is crucial for its preoperative diagnosis, especially in the presence of an inguinal mass associated with cyclic changes in size and pain severity. Its standard management is surgical excision.

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Section: Discussionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Inguinal Endometriosis in a Nulliparous Woman Mimicking an Inguinal Hernia: A Case Report with Literature Review

et al. 2021

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“…This can lead to emergent situations such as strangulation obstruction of the intestine or torsion of the ovary. Additionally, part of the HCN may contain endometrial tissue, causing periodic swelling during menstruation [ 3 , 12 ]. Due to these potential complications, timely diagnosis and prompt treatment of HCN is critical [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Hydrocele of canal of Nuck (HCN) is a rare disease in adult women that is difficult to diagnose by preoperative imaging alone, and some patients may have a complicated inguinal hernia [ 1 – 3 ]. The traditional treatment method is to completely remove the hydrocele through an open anterior approach surgery [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic assisted hydrocelectomy of the canal of Nuck: a case report

et al. 2021

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Background Accurate diagnosis and complete resection of hydrocele of canal of Nuck (HCN) is still a challenge for surgeons. Case presentation A 28-year-old woman presented with a suspected inguinal hernia due to swelling in her right groin and was introduced for surgical treatment. Computed tomography scan revealed local cyst formation in the right groin and eliminated intestinal incarceration. In order to further confirm the diagnosis, we used laparoscopic exploration; after excluding a combined hernia, HCN was surgically removed using a conventional anterior peritoneal approach and a mesh patch repair was not needed. Postoperative pathology results showed no endometriosis or malignancy. Conclusions Laparoscopic assisted anterior approach provides both an accurate intraoperative diagnosis and a quick complete resection of HCN; it is the preferred treatment for women of childbearing age with pure HCN.

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Laparoscopic surgery for endometriosis of the round ligament: A case of a patient with right-sided inguinal pain

Rokhgireh,

MehdizadehKashi,

Noroozi

et al. 2024

Womens Health (Lond Engl)

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Round ligament endometriosis is a rare phenomenon reported in approximately 0.3% to 0.6% of endometriosis cases. Presurgical diagnosis is carried out for about 50% of the cases. The association of the right-sided inguinal hernia, nonspecific pain in the organs, and no history of surgery or labor make the diagnosis intricate. We report a case of endometriosis of the round ligament in a 39-year-old woman who complained of intense pain in the right groin during the menstrual period for about 4 years, with no complaints of bulging or change in the size of the mentioned area. The clinical suspicion of inguinal endometriosis, supported by sonography and magnetic resonance imaging, was confirmed by histological examination of the surgical specimen after laparoscopic surgery, which included the mass and the extraperitoneal segment of the round ligament. After surgery, the patient’s pain disappeared completely. The round ligament endometriosis or endometriosis of the inguinal region could be considered an important differential diagnosis in women of reproductive age without a history of surgery who presented with inguinal region pain during menstruation but no clear mass was palpable in the physical exam.

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Endometriosis of the Inguinal Canal Mimicking a Hydrocele of the Canal of Nuck

Cited by 6 publications

References 15 publications

Inguinal Endometriosis in a Nulliparous Woman Mimicking an Inguinal Hernia: A Case Report with Literature Review

Inguinal Endometriosis in a Nulliparous Woman Mimicking an Inguinal Hernia: A Case Report with Literature Review

Laparoscopic assisted hydrocelectomy of the canal of Nuck: a case report

Laparoscopic surgery for endometriosis of the round ligament: A case of a patient with right-sided inguinal pain

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