Endometriosis within the Inguinal Canal: A case report

Genital / Reproductive system female, Pelvis, CT, Ultrasound, Contrast agent-intravenous, Cysts Authors: S. Tan; Perth, WA/AU DOI: 10.26044/ranzcr2021/R-0038 Learning objectives Endometriosis is a disease characterised by ectopic endometrial stroma within extra-uterine sites.1 These are typically found within the ovary, pelvic space, or attached to the uterine ligaments.2 Inguinal endometriosis is characterised by the presence of endometrial tissue within the round ligament.1 This was first described in 1896 with less than 30 cases reported since.3 Due to its rarity, this can be a diagnostic dilemma and the presence of catamenial symptoms should raise suspicion for endometriosis.4 An endometrioma is a localised cystic structure comprised of endometrial...

42 year old female presents to the Emergency Department with a palpable right groin mass, which has been increasing in size over the past three days. Patient reported no significant medical history, specifically, no known gynaecological issues. Clinical examination revealed an immobile, non-fluctuant tender mass at the right groin region. Patient was afebrile and denied urinary symptoms. Imaging findings OR Procedure details Initial ultrasound demonstrated a large multiloculated, non-compressible avascular cystic mass tracking along the inguinal canal towards the deep inguinal ring. This lesion was lateral to the inferior epigastric vessels. The mass was irreducible with manual probe pressure or Valsalva manoeuvre. Small adjacent lymph nodes were present. Due to the ongoing clinical uncertainty of the underlying pathology, contrast-enhanced CT of the abdomen and pelvis performed. This demonstrated a complex cystic structure that was adherent to the broad ligament. This structure extended from the right deep inguinal...

Despite being relatively rare, it is important to be aware of extra-pelvic endometriosis due to the small possibility of malignant transformation.

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