Canal of Nuck Cyst with Endometriosis Presenting as a Left Inguinal Mass: A Rare Clinical Variant

Celal Akdemir, Gülin Özuyar Şimşek, Şimal Çoban, Murat Güner, Muzaffer Şancı
2025 · doi:10.36516/jocass.1753208 · W7092473070
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This case report describes a 34-year-old woman with a rare canal of Nuck cyst in her left inguinal region, which was successfully excised and found to contain endometriosis within its wall.

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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 a rare presentation of endometriosis arising in the canal of Nuck, where it presented clinically as a left inguinal mass. The authors report diagnostic and evaluation steps at a clinical level and confirm the diagnosis histopathologically, emphasizing the atypical location and presentation. A key limitation is that, as a single case report, the findings cannot establish incidence or generalizable diagnostic criteria. This paper is centrally about endometriosis — specifically endometriosis involving the canal of Nuck presenting as an inguinal mass.

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Abstract

A cyst of the canal of Nuck is a rare clinical entity in females, resulting from the failure of obliteration of the processus vaginalis. Although it is typically diagnosed in the pediatric population, it is extremely rare in adult women and often misdiagnosed as an inguinal hernia, leading to delays in appropriate treatment. Clinically, it usually presents as a painless, fluctuating mass in the inguinal region. Ultrasonography is the primary imaging modality for diagnosis, while magnetic resonance imaging (MRI) can further delineate the origin and anatomical relationships of the lesion. Surgical excision remains the standard treatment approach. Herein, we present the case of a 34-year-old woman who presented with a painless swelling in the left inguinal region. A preoperative diagnosis was established based on imaging findings, and the lesion was surgically excised. Histopathological examination revealed a focus of endometriosis within the cyst wall. This case highlights the importance of considering rare coexisting pathologies such as endometriosis in the differential diagnosis of canal of Nuck cysts in adult women and aims to raise clinical awareness of this uncommon presentation.
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References

- 1. Kohlhauser M, Pirsch JV, Maier T, Viertler C, Fegerl R. The cyst of the canal of Nuck: anatomy, diagnostic and treatment of a very rare diagnosis—a case report of an adult woman and narrative review of the literature. Medicina (Kaunas). 2022;58(10):1353. [Crossref] - 2. Prodromidou A, Paspala A, Schizas D, Spartalis E, Nastos C, Machairas N. Cyst of the canal of Nuck in adult females: a case report and systematic review. Biomed Rep. 2020;12(6):333–8. [Crossref] - 3. Kim KS, Choi JH, Kim HM, Kim KP, Kwon YJ, Hwang JH, et al. Hydrocele of the canal of Nuck in a female adult. Arch Plast Surg. 2016;43(5):476–8. [Crossref] - 4. Nava CM, Geng B, Litchinko A, Jaccard C, Egger B. Cyst of the canal of Nuck in an adult female patient: a case report on surgical management. Int J Surg Case Rep. 2025;126:110807. [Crossref] - 5. Singh A, Chauhan E, Kalantri A, Gupta S. Hydrocele and endometriosis of the canal of Nuck in two adults: a look at the imaging features. BMJ Case Rep. 2023;16(10):e255970. [Crossref] - 6. European Journal of Case Reports in Internal Medicine. Going against the grain: a case report of an endometriosis in the canal of Nuck [Internet]. Available from: https://www.ejcrim.com/index.php/EJCRIM/article/view/5024. Accessed: 2025 Jul 20. [Crossref] - 7. Okoshi K, Mizumoto M, Kinoshita K. Endometriosis-associated hydrocele of the canal of Nuck with immunohistochemical confirmation: a case report. J Med Case Rep. 2017;11(1):354. [Crossref] Details Primary Language English Subjects General Surgery, Gynecologic Oncology Surgery, Pathology Journal Section Case Report Authors Celal Akdemir * 0000-0002-4070-7583 Türkiye Şimal Çoban 0000-0001-6398-9694 Türkiye Murat Güner 0000-0002-3463-8550 Türkiye Muzaffer Sancı 0000-0002-8494-4302 Türkiye Publication Date September 30, 2025 Submission Date July 29, 2025 Acceptance Date September 12, 2025 Published in Issue Year 2025 Volume: 8 Number: 3

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endometriosis

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