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This paper reports three case reports of women with inguinal endometriosis treated with conventional extracorporeal excision combined with laparoscopy. Across the three patients (ages 35–40), MRI identified presumed inguinal lesions, histology confirmed endometriosis after excision, and two cases included additional surgical context: one had pelvic endometriosis with symptom improvement but later recurrence requiring re-excision and inguinal hernia surgery, and another had pelvic endometriosis with peritoneal adhesions and an inguinal hernia diagnosed and treated during the same operative setting. The paper’s main limitation is that it is a small, descriptive case series without comparative outcomes beyond these individual experiences. This paper is centrally about endometriosis — specifically surgical management of inguinal endometriosis using extracorporeal excision plus laparoscopy.
Abstract
We report three cases of women with inguinal endometriosis who were treated with conventional extracorporeal excision and laparoscopy. Case 1: A 38-year-old woman complained of a painful nodule in the left inguinal region. Magnetic resonance imaging (MRI) revealed a 2-cm fibrous tumor at the left inguinal region presumed to be an endometriotic lesion. We performed an extracorporeal tumor excision and laparoscopy. The patient had pelvic endometriosis. The left inguinal tumor was excised and endometriosis was confirmed histologically. Case 2: A 40-year-old woman with previous history of ovarian endometrioma cystectomy presented with left inguinal swelling and pain during menstruation. MRI revealed a 2-cm fibrous tumor in the left inguinal region presumed to be endometriosis. Extracorporeal tumor excision and laparoscopy were performed. Endometriosis was confirmed histologically. Her symptoms improved after surgery, but four months after the first procedure, she noticed recurrence of the left inguinal tumor. She underwent a re-excision of the tumor along with inguinal hernia surgery (protrusive approach, mesh plug procedure). Case 3: A 35-year-old woman with a painful right inguinal nodule, suspected to be endometriosis, was treated with extracorporeal tumor excision and laparoscopy. During surgery, in addition to the presence of pelvic endometriosis and peritoneal adhesion, right inguinal hernia was diagnosed and inguinal hernia surgery (Hybrid-TAPP; transabdominal pre-peritoneal approach procedure) was performed along with the excision of the right inguinal tumor by a general surgeon. After surgery, she was symptom free with the support of oral contraceptives. Inguinal endometriosis is rare, but may need appropriate surgical and medical interventions. We discuss the clinical management for inguinal endometriosis and the significance of laparoscopy in such cases.
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症例報告
鼠径部子宮内膜症に対して腹腔鏡を併用した外科的アプローチを行った3例
2018 年 34 巻 1 号 p. 134-138
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We report three cases of women with inguinal endometriosis who were treated with conventional extracorporeal excision and laparoscopy. Case 1: A 38-year-old woman complained of a painful nodule in the left inguinal region. Magnetic resonance imaging (MRI) revealed a 2-cm fibrous tumor at the left inguinal region presumed to be an endometriotic lesion. We performed an extracorporeal tumor excision and laparoscopy. The patient had pelvic endometriosis. The left inguinal tumor was excised and endometriosis was confirmed histologically. Case 2: A 40-year-old woman with previous history of ovarian endometrioma cystectomy presented with left inguinal swelling and pain during menstruation. MRI revealed a 2-cm fibrous tumor in the left inguinal region presumed to be endometriosis. Extracorporeal tumor excision and laparoscopy were performed. Endometriosis was confirmed histologically. Her symptoms improved after surgery, but four months after the first procedure, she noticed recurrence of the left inguinal tumor. She underwent a re-excision of the tumor along with inguinal hernia surgery (protrusive approach, mesh plug procedure). Case 3: A 35-year-old woman with a painful right inguinal nodule, suspected to be endometriosis, was treated with extracorporeal tumor excision and laparoscopy. During surgery, in addition to the presence of pelvic endometriosis and peritoneal adhesion, right inguinal hernia was diagnosed and inguinal hernia surgery (Hybrid-TAPP; transabdominal pre-peritoneal approach procedure) was performed along with the excision of the right inguinal tumor by a general surgeon. After surgery, she was symptom free with the support of oral contraceptives. Inguinal endometriosis is rare, but may need appropriate surgical and medical interventions. We discuss the clinical management for inguinal endometriosis and the significance of laparoscopy in such cases.
© 2018 日本産科婦人科内視鏡学会
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