An atypical manifestation of inguinal endometriosis in the extra pelvic part of the round ligament: a case report

Vito Chiàntera, Elene Abesadze, Mohamed Gamal Ibrahim, Anna M. Dückelmann, Sylvia Mechsner
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2016 · pp. 3202–3207 · doi:10.18203/2320-1770.ijrcog20163012 · W2515887231
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case report details the diagnosis and surgical treatment of a rare inguinal endometriosis case affecting the round ligament, confirmed intraoperatively and histologically.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This paper is a case report describing an atypical presentation of inguinal endometriosis arising from the extra-peritoneal portion of the round ligament in a 29-year-old patient with a painful, progressively enlarging groin induration, and it evaluates diagnostic and surgical management. Preoperative CT, PET-CT, and biopsy did not confirm endometriosis; therefore, open inguinal surgery was performed, with intraoperative cryosection confirming endometriosis and concurrent laparoscopy showing peritoneal endometriosis and alteration of the inner round ligament extending toward the inner inguinal channel. Immunohistochemistry demonstrated endometriotic tissue surrounded by smooth muscle metaplasia, and all lesions were removed with groin reconstruction, with the patient reported as symptom-free after surgical treatment. This paper is centrally about endometriosis — specifically inguinal endometriosis of the extra- and intra-peritoneal portions of the uterine round ligament.

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Abstract

Establishing the diagnostic and surgical management of the inguinal Endometriosis, with further investigation of the biological character.The imaging findings of CT and PET-CT, biopsy, ultrasound, open surgery of the inguinal region with intraoperative cryosection, confirmation and evaluation of tissue infiltration by endometriosis, laparoscopic removal of all endometriotic lesions, reconstruction of the groin. Based on the history of the 29-year-old patient, suffering from a painful growing induration of the inguinal region. Immunohistochemistry performed, in order to analyze the character of the inguinal endometriosis.CT, PET-CT and biopsy did not confirm the diagnosis of endometriosis. Considering, the progressive symptoms of the patient, was performed the surgical intervention. Open surgery of the inguinal region, with a preparation and separation of the groin fibrotic mass lead to the finding of an affected extra-peritoneal portion of the round ligament. Intraoperative cryosection confirmed endometriosis. Simultaneous laparoscopy showed peritoneal endometriosis (rASRM I) and an alteration of the inner round ligament, involving the inner inguinal channel in this process. All endometriotic lesions were removed and the inguinal region reconstructed. The immunohistochemical staining gave evidence of the endometriotic tissue, surrounded by smooth muscle metaplasia.We consider that, reporting this rare case of endometriosis, based on a case report and a literature review, affecting intra and extra peritoneal portion of the round ligament, is an important aid to avoid a wrong diagnosis and method of therapy in future. Our data demonstrated the fully recovery of the patient, after surgical treatment, reporting symptom-free status.

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Outcome instruments

rASRM

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endometriosis

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