{"paper_id":"1020a509-7560-4a62-b394-0cc154f949b7","body_text":"Abstract\nIntroduction\nEndometriosis is a chronic, oestrogen-dependent condition, defined as extra-uterine, functional endometrial tissue. We report a case of endometriosis of extra-inguinal part of the round ligament, in near proximity to pubic bone. To our knowledge, this is the first case report in the searched English literature.\nCase report\nA 31-year-old female patient, nullipara, presented with an unrelated to menstruation, right suprapubic painful swelling of 6 months duration. Her medical history was free. The patient has been receiving contraception for the last 3 years. Colour Doppler and computed tomography showed a spindle-shaped lobe, of inhomogeneous echomorphology, with dimensions of 2.77 × 1.29 cm and relative contamination, which appeared in continuation with the ipsilateral rectus abdominis muscle. Intraoperatively, under general anaesthesia, a mass of the right round ligament of the uterus was found in the ligament’s insertion to the pubic bone. The extra-inguinal part of the right round ligament was excised and the intra-pelvic part was sutured to the ground of the inguinal canal.\nResult\nThe histological and immunohistochemical characteristics of the specimen were consistent with endometriosis. Her recovery was uneventful and the patient was discharged on the 2nd postoperative day.\nConclusion\nEndometriosis of the round ligament of the uterus, should be taken into consideration in the differential diagnosis in cases of extra-inguinal swelling in women of childbearing ages, even in cases with a free medical history.\nSimilar content being viewed by others\nReferences\nVercellini P, Vigano P, Somigliana E, et al. Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol 2014;10:261–75.\nMehedintu C, Plotogea MN, Ionescu S, et al. Endometriosis still a challenge. J Med Life 2014;15:349–57.\nDavis AC, Goldberg JM. Extrapelvic endometriosis. Semin Reprod Med 2017;35:98–101.\nBurney RO, Giudice LC. Pathogenesis and pathophysiology of endometriosis. Fertil Steril 2012;98:511–9.\nWolfhagen N, Simons NE, de Jong KH, et al. Inguinal endometriosis, a rare entity of which surgeons should be aware: Clinical aspects and long — term follow — up of nine cases. Hernia 2018;22:881–6.\nKhetan N, Torkington J, Watkin A, et al. Endometriosis: presentation to general surgeons. Ann R Coll Surg Engl 1999;81:255–9.\nBennett GL, Slywotsky CM, Cantera M, et al. Unusual Manifestations and Complications of Endometriosis—Spectrum of Imaging Findings: Self-Assessment Module. AJR Am J Roentgenol 2010;194(6 suppl):84–8.\nTran-Harding K, Nair RT, Dawkins A, et al. Endometriosis revisited: An imaging review of the usual and unusual manifestations with pathological correlation. Clin Imaging 2018;52:163–71.\nBulun SE, Yilmaz BD, Sison C, et al. Endometriosis. Endocr Rev 2019;40:1048–79.\nYang DM, Kim HC, Kim SW, et al. Groin abnormalities: ultrasonografic and clinicl findings. Ultrasonography 2020;39:166–77.\nHiroaki Niitsu, Hiroaki Tsumura, Tetsuya Kanehir, et al. Clinical characteristics and surgical treatment for inguinal endometriosis in young women of reproductive age. Dig Surg 2019;36:166–72.\nHagiwara Y, Hatori M, Moriya T, et al. Inguinal endometriosis attaching to the round ligament. Australas Radiol 2007;51:91–4.\nKapan M, Kapan S, Durgun AV, et al. Inguinal endometriosis. Arch Gynecol Obstet 2005;271:76–8.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nAdditional information\nInformed Consent\nWritten informed consent was obtained from the patient for publication of her personal data\nConflict of Interests\nAuthors have no conflict of interests\nRights and permissions\nAbout this article\nCite this article\nVakalopoulou, M., Skandalou, E., Tzigalidis, T. et al. Extra-Inguinal Round Ligament Endometriosis Near to Pubic Bone. Report of a Case. Hellenic J Surg 92, 205–207 (2020). https://doi.org/10.1007/s13126-020-0579-y\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s13126-020-0579-y","source_license":"CC0","license_restricted":false}