Inguinal Endometriosis: Three Cases and Literature Review

Stylianos Apostolidis, Stelios Apostolidis, Antonios Michalopoulos, Antonis Michalopoulos, Theodossis S. Papavramidis, Vasileios Papadopoulos, Vassilis N. Papadopoulos, Daniel Paramythiotis, Nick Harlaftis, Harlaftis N
Southern medical journal · 2009 · vol. 102(2) , pp. 206–207 · doi:10.1097/smj.0b013e318186d36e · PMID:19139703 · W135158482
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

This paper presents three cases of round ligament endometriosis, often misdiagnosed as hernia, highlighting the need for histologic confirmation and surgical treatment for this rare condition in women of reproductive age.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This paper presents three cases of endometriosis infiltrating the round ligament in fertile women, in which the initial diagnosis was an irreducible inguinal hernia due to unusual preoperative symptoms. The authors report that histologic examination was the basis for diagnosis and emphasize that inguinal endometriosis should be considered for painful inguinal masses showing menstrual-related changes, noting its rarity as a diagnostic caveat. They state that surgery is the treatment of choice and is curative, and they suggest performing laparoscopy during the same operation to evaluate intraperitoneal disease. This paper is centrally about endometriosis — specifically inguinal endometriosis involving the round ligament and its diagnostic challenges.

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Abstract

Three cases of endometriosis infiltrating the round ligament are presented. The initial diagnosis was irreducible hernia, since this rare nosologic entity often causes unusual preoperative symptoms and diagnostic problems. Diagnosis is frequently made by histologic examination. The rarity of inguinal endometriosis should not exclude it from a possible diagnosis in cases with a painful mass in the inguinal region in a fertile woman, especially if the groin mass is associated in size and tenderness with menstrual variability. Surgery is the treatment of choice and is curative; laparoscopy is suggested during the same operation to evaluate the intraperitoneal conditions.
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Abstract

Abstract:Three cases of endometriosis infiltrating the round ligament are presented. The initial diagnosis was irreducible hernia, since this rare nosologic entity often causes unusual preoperative symptoms and diagnostic problems. Diagnosis is frequently made by histologic examination. The rarity of inguinal endometriosis should not exclude it from a possible diagnosis in cases with a painful mass in the inguinal region in a fertile woman, especially if the groin mass is associated in size and tenderness with menstrual variability. Surgery is the treatment of choice and is curative; laparoscopy is suggested during the same operation to evaluate the intraperitoneal conditions. This content is limited to qualifying members. If you have an existing account please login now to access this article or view purchase options. Create a free account, then purchase this article to download or access it online for 24 hours. Create a free account, then purchase a subscription to get complete access to all articles for a full year.

References

References1.Astore L. Rare localization of so-called “external endometriosis” [intestinal, inguinal umbilical, cicatricial]. Arch De Vecchi Anat Patol 1980;64:19–58.AstoreLRare localization of so-called “external endometriosis” [intestinal, inguinal umbilical, cicatricial].Arch De Vecchi Anat Patol19806419-582.Bergqvist A. Different types of extragenital endometriosis: a review. Gynecol Endocrinol 1993;7:207–221.BergqvistADifferent types of extragenital endometriosis: a review.Gynecol Endocrinol19937207-2213.Proposito D, Negro P, Gossetti F, et al. Extrauterine endometriosis: what interest for the general surgeon? Presentation of 3 clinical cases and review of the literature. Chir Ital 2002;54:699–708.PropositoD]]NegroP]]GossettiF&etal;Extrauterine endometriosis: what interest for the general surgeon? Presentation of 3 clinical cases and review of the literature.Chir Ital200254699-7084.Licheri S, Pisano G, Erdas E, et al. Endometriosis of the round ligament: description of a clinical case and review of the literature. Hernia 2005;9:294–297.LicheriS]]PisanoG]]ErdasE&etal;Endometriosis of the round ligament: description of a clinical case and review of the literature.Hernia20059294-2975.Miranda L, Settembre A, Capasso P, et al. Inguinal endometriosis or irreducible hernia? A difficult preoperative diagnosis. Hernia 2001;5:47–49.MirandaL]]SettembreA]]CapassoP&etal;Inguinal endometriosis or irreducible hernia? A difficult preoperative diagnosis.Hernia2001547-496.Sataloff DM, LaVorgna KA, McFarland MM. Extrapelvic endometriosis presenting as a hernia: clinical reports and review of the literature. Surgery 1989;l05:l09–112.7.Cristalli B, Raguin E, Nos C, et al. Inguinal hernia and endometriosis. J Gynecol Obstet Biol Reprod (Paris) 1993;22:149–150.CristalliB]]RaguinE]]NosC&etal;Inguinal hernia and endometriosis.J Gynecol Obstet Biol Reprod (Paris)199322149-1508.Clausen I, Nielsen KT. Endometriosis in the groin. Int J Gynaecol Obstet 1987;25:469–471.ClausenI]]NielsenKTEndometriosis in the groin.Int J Gynaecol Obstet198725469-4719.Fimmano A, Coppola Bottazzi E, Cirillo C, et al. Inguinal endometriosis. Chir Ital 2005;57:211–214.FimmanoA]]Coppola BottazziE]]CirilloC&etal;Inguinal endometriosis.Chir Ital200557211-21410.Douglas C, Rotimi O. Extragenital endometriosis—a clinicopathological review of a Glasgow hospital experience with case illustrations. J Obstet Gynaecol 2004;24:804–808.DouglasC]]RotimiOExtragenital endometriosis—a clinicopathological review of a Glasgow hospital experience with case illustrations.J Obstet Gynaecol200424804-80811.Kapan M, Kapan S, Durgun AV, et al. Inguinal endometriosis. Arch Gynecol Obstet 2005;271:76–78.KapanM]]KapanS]]DurgunAV&etal;Inguinal endometriosis.Arch Gynecol Obstet200527176-7812.Oyetunde O, Akang EE. Endometriosis presenting as a groin tumour: case report. East Afr Med J 2000;77:398–399.OyetundeO]]AkangEEEndometriosis presenting as a groin tumour: case report.East Afr Med J200077398-39913.Blanco RG, Parithivel VS, Shah AK, et al. Abdominal wall endometriomas. Am J Surg 2003;185:596–598.BlancoRG]]ParithivelVS]]ShahAK&etal;Abdominal wall endometriomas.Am J Surg2003185596-59814.Hagiwara Y, Hatori M, Katoh H, et al. A case of inguinal endometriosis with difficulty in preoperative diagnosis. Ups J Med Sci 2002;107:159–164.HagiwaraY]]HatoriM]]KatohH&etal;A case of inguinal endometriosis with difficulty in preoperative diagnosis.Ups J Med Sci2002107159-16415.Candiani GB, Vercellini P, Fedele L, et al. Inguinal endometriosis: pathogenetic and clinical implications. Obstet Gynecol 1991;78:191–194.CandianiGB]]VercelliniP]]FedeleL&etal;Inguinal endometriosis: pathogenetic and clinical implications.Obstet Gynecol199178191-194

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Inguinal Canal Round Ligament of Uterus Adult Endometriosis Endometriosis Female Humans Inguinal Canal Round Ligament of Uterus

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (14)

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