Left isolated inguinal endometriosis without pelvic endometriosis associated with PCOS and review of literature

Cemil Kaya, Bilge Sezin Akhan, H Ertürk
In: Journal of Health Sciences and Medicine · 2026 · vol. 9(3) , pp. 852–857 · doi:10.32322/jhsm.1839088 · W7163637202
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case describes a 40-year-old woman with PCOS and left inguinal endometriosis, highlighting the rare association of these conditions even without pelvic endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

This paper is a case report describing left isolated inguinal endometriosis without pelvic endometriosis, occurring in association with polycystic ovary syndrome (PCOS), and it includes a review of relevant literature. It focuses on the presentation of this specific localization and the clinical context of PCOS, rather than a population-based cohort or experimental study. A stated limitation of case reports and narrative reviews is that they cannot establish generalizable incidence, risk factors, or causal relationships from a single patient experience. This paper is centrally about endometriosis — specifically, isolated inguinal endometriosis occurring without pelvic disease in a patient with PCOS.

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Abstract

The coexistence of polycystic ovary syndrome (PCOS) and endometriosis is rare. Inguinal endometriosis (IEM) is an uncommon extrapelvic form of endometriosis, accounting for approximately 0.3-0.6% of all cases. It typically presents as inguinal swelling with cyclical pain and enlargement related to the menstrual cycle. A 40-year-old woman with a known diagnosis of type 1 PCOS and a history of two cesarean sections presented with a painful mass in the left inguinal region. The pain and swelling were cyclical in nature and became more pronounced during menstruation. The patient reported that her symptoms had worsened following the discontinuation of combined oral contraceptives, which she had been using for PCOS management. Physical examination revealed a tender mass in the left groin. Ultrasonography and magnetic resonance imaging demonstrated a lesion in the left inguinal region suggestive of endometriosis. Based on clinical and radiological findings, surgical intervention was planned. The patient underwent laparotomy, during which the left round ligament and the associated mass were completely excised. Intraoperative findings were consistent with endometriosis. The postoperative course was uneventful. Histopathological examination of the excised tissue confirmed the diagnosis of endometriosis. PCOS can be associated with inguinal endometriosis even without pelvic endometriosis.
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- Teede HJ, Misso ML, Costello MF, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Fertil Steril. 2018;110(3):364-379. doi:10.1016/j.fertnstert.2018.05.004 - Mascaretti G, Di Berardino C, Mastrocola N, et al. Endometriosis: rare localizations in two cases. Clin Exp Obstet Gynecol. 2007;34:123-125. - Mu B, Zhang Z, Liu C, et al. Long term follow-up of inguinal endometriosis. BMC Womens Health. 2021;21(1):90. doi:10.1186/s12905-021-01235-2 - Zarcone R, Longo M, Ferrara G, Cardone A. Association between inguinal endometriosis and polycystic ovary. Minerva Ginecol 1992; 44(4):197-200 - Lo L, Lee R. Spontaneous cutaneous endometriosis of the mons pubis: diagnosis, treatment, and review of the literature. J Endometr Pelvic Pain Dis. 2018;10:36-38. - Watanabe Y, Suzuki R, Kinoshita M, Hirota M Inguinal endometriosis with a disappearing mass preoperatively: a case report. Int J Surg Case Rep. 2022;91:106781. doi:10.1016/j.ijscr.2022.106781 - Zarcone R, Longo M, Ferrara G, Cardone A. Association between inguinal endometriosis and polycyctic ovary. Minerva Ginecol. 1992; 44(4):197-200. - Tan H, Long P, Xiao H.Dissecting the shared genetic architecture between endometriosis and polycystic ovary syndrome. Front Endocrinol (Lausanne). 2024;15:1359236. doi:10.3389/fendo.2024.1359236 Details Primary Language English Subjects Obstetrics and Gynaecology Journal Section Case Report Authors Cemil Kaya * 0000-0001-6764-4714 Türkiye Bilge Sezin Akhan 0000-0002-4647-7053 Türkiye Hakan Ertürk 0000-0002-5730-9215 Türkiye Publication Date May 19, 2026 Submission Date December 9, 2025 Acceptance Date March 23, 2026 Published in Issue Year 2026 Volume: 9 Number: 3

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