Diagnostic challenges and surgical options for cysts of the canal of Nuck in adults: Two cases report.

RATIONALE: Cyst of the canal of Nuck is a very rare female hydrocele, which is often caused by developmental disorders. The incidence of this disease is very low in the world, and misdiagnosis and missed diagnosis often occur due to insufficient understanding of it by clinical staff. We present these 2 case studies with the objective of enhancing awareness and comprehension of the disease, as well as offering valuable insights for its management and treatment.

PATIENT CONCERNS: A 38-year-old female patient was admitted to the hospital with a reversible mass in the left groin area that was painful during the menstrual period.A 50-year-old emergency patient who was admitted to the hospital for the discovery of an incarcerated mass in the left groin area for 2 hours.

DIAGNOSES: In case 1, inguinal hernia was considered before operation, and the canal Nuck type I complicated with hernia was found intraoperatively.In case 2, cyst of the canal of Nuck was considered before operation, and the canal Nuck type Ⅲ was found intraoperatively.

INTERVENTIONS: In case 1, the patient was given tension-free hernioplasty combined with resection of a cyst of the round ligament of uterus. In case 2, the patient underwent transabdominal preperitoneal prosthesis plus cyst dissection of the round ligament of uterus.

OUTCOMES: In both patients, the mass in the groin area was completely removed and the pain caused by the mass disappeared.

LESSONS: These 2 cases emphasize that the possibility of hydrocele of the canal Nuck should be taken into account when discovering a female groin mass. Ultrasound, computed tomography, and magnetic resonance imaging are conducive to diagnosis, but the diagnosis also needs intraoperative findings and postoperative pathology. For this disease, surgical treatment is the first choice.For cyst of the canal of Nuck type I, transabdominal preperitoneal patch implantation is recommended. When cyst of the canal of Nuck type III is found under laparoscopy and it is difficult to simply use laparoscopic dissection, a small auxiliary incision can be made in the inguinal region to preserve the round ligament of the uterus and completely peel off the cyst.