Differential diagnosis of inguinal region masses in gynecological practice

V. F. Bezhenar, V. Yu. Ulchenko, A. E. Grigorian, D. V. Fedosova, A. B. Ismogulova, A. B. Todua, I. A. Kuznecova, A. S. Smirnov
In: Grekov's Bulletin of Surgery · 2026 · vol. 184(6) , pp. 29–37 · doi:10.24884/0042-4625-2025-184-6-29-37 · W7129081086
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This study analyzed clinical, imaging, and pathological data from six women with inguinal masses, finding both cyst of the canal of Nuck and round ligament endometriosis, highlighting diagnostic complexity.

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Abstract

INTRODUCTION. Inguinal masses in women have heterogeneous etiologies and include both surgical and gynecological pathologies, which makes differential diagnosis challenging. Particular focus is placed on distinguishing inguinal extragenital endometriosis from a congenital abnormality – the cyst of the canal of Nuck. The OBJECTIVE was to analyze the clinical and anamnestic, instrumental, and morphological characteristics of inguinal masses in women of reproductive age. METHODS AND MATERIALS. The study included six reproductive-age women presenting with inguinal masses. Medical history, clinical symptoms, ultrasound (US) and magnetic resonance imaging (MRI) findings, type of surgical intervention, and histopathological evaluation were analyzed. Quantitative variables are presented as median (Me) and interquartile range [Q1; Q3]. RESULTS. The median age was 43 [39; 44] years, and the median body mass index was 20.4 [19.1; 22.1] kg/m². Catamenial symptoms were observed in 50 % of patients, and the median pain severity score using the Visual Analogue Scale was 0 [0; 8]. Preoperative imaging suggested the cyst of the canal of Nuck in 67 % of cases. Histopathological examination confirmed the cyst of the canal of Nuck in four (67 %) patients, whereas in two (33 %) patients, round ligament endometriosis was identified. All patients underwent surgical treatment, and no postoperative complications occurred. CONCLUSIONS. The presented clinical observations illustrate the diagnostic complexity of inguinal masses in women. The findings support the necessity of a multidisciplinary approach, the use of high-resolution imaging modalities, and surgical verification for definitive diagnosis.

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endometriosis

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