Extra-Inguinal Round Ligament Endometriosis Near to Pubic Bone. Report of a Case

In: Hellenic Journal of Surgery · 2020 · vol. 92(5-6) , pp. 205–207 · doi:10.1007/s13126-020-0579-y · W3139103509
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⚙ AI-generated summary by gemini-2.5-flash-lite+body, 2026-06-13 ⓘ

This case report describes a rare instance of endometriosis located in the extra-inguinal portion of the round ligament near the pubic bone in a 31-year-old female.

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This paper reports a 31-year-old nulliparous woman with a right suprapubic, non–menstruation-related painful swelling present for 6 months, where imaging (color Doppler ultrasound and computed tomography) showed a spindle-shaped, inhomogeneous lobe contiguous with the ipsilateral rectus abdominis muscle near the pubic bone. At surgery, an endometriosis-consistent mass was found in the extra-inguinal part of the right round ligament at its insertion to the pubic bone, and the extra-inguinal portion was excised with intra-pelvic suturing to the inguinal canal ground; histology and immunohistochemistry supported endometriosis. The authors note this is the first case report in the searched English literature. This paper is centrally about endometriosis — specifically, extra-inguinal round ligament endometriosis near the pubic bone.

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Abstract

Introduction Endometriosis 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. Case report A 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.

Result

The 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.

Conclusion

Endometriosis 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. Similar content being viewed by others

References

Vercellini P, Vigano P, Somigliana E, et al. Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol 2014;10:261–75. Mehedintu C, Plotogea MN, Ionescu S, et al. Endometriosis still a challenge. J Med Life 2014;15:349–57. Davis AC, Goldberg JM. Extrapelvic endometriosis. Semin Reprod Med 2017;35:98–101. Burney RO, Giudice LC. Pathogenesis and pathophysiology of endometriosis. Fertil Steril 2012;98:511–9. Wolfhagen 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. Khetan N, Torkington J, Watkin A, et al. Endometriosis: presentation to general surgeons. Ann R Coll Surg Engl 1999;81:255–9. Bennett 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. Tran-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. Bulun SE, Yilmaz BD, Sison C, et al. Endometriosis. Endocr Rev 2019;40:1048–79. Yang DM, Kim HC, Kim SW, et al. Groin abnormalities: ultrasonografic and clinicl findings. Ultrasonography 2020;39:166–77. Hiroaki 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. Hagiwara Y, Hatori M, Moriya T, et al. Inguinal endometriosis attaching to the round ligament. Australas Radiol 2007;51:91–4. Kapan M, Kapan S, Durgun AV, et al. Inguinal endometriosis. Arch Gynecol Obstet 2005;271:76–8. Author information Authors and Affiliations Corresponding author Additional information Informed Consent Written informed consent was obtained from the patient for publication of her personal data Conflict of Interests Authors have no conflict of interests Rights and permissions About this article Cite this article Vakalopoulou, 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 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s13126-020-0579-y

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