Abstract / Summary
Introduction: Endometriosis is defined as the presence of functional endometrial tissue outside the uterine cavity. The pelvic organs are most frequently involved, but there are rare reports of extrapelvic sites including bowel, diaphragm, pleura, and inguinal canal. Inguinal endometriosis is a rare disease which may present clinically as other inguinal pathologies especially when involving the round ligament. Case Report: We describe the case of a 44-year-old woman who has been experiencing episodic, cyclical right groin pain for a period of two years. Transabdominal ultrasonography revealed a 16 mm solid hypoechoic mass in the right inguinal region, and magnetic resonance imaging demonstrated a nodular lesion along the right round ligament containing focal T1-hyperintense hemorrhagic foci. Because the cyclical pain persisted after dienogest had to be discontinued for migraine, and because imaging remained suggestive but not diagnostic, complete surgical excision was performed. Histopathological examination confirmed endometriosis of the round ligament. At six months of follow-up the patient was free of symptoms with no evidence of recurrence. Conclusion: Inguinal canal endometriosis should be considered in the differential diagnosis of inguinal masses and groin pain in women of reproductive age. Surgical excision remains the gold standard for both diagnosis and treatment.