A rare case of canal of Nuck cyst in a nulliparous woman of reproductive age: A case report and literature review.

The cyst of the canal of Nuck is a rare developmental disorder of the female inguinal region. It arises from the failure of the obliteration of the peritoneal fold accompanying the round ligament through the inguinal canal. Although predominantly encountered in the pediatric population, its occurrence in women of reproductive age presents a significant diagnostic challenge, given the overlap with more common inguinal pathologies. This report describes the case of a 33-year-old nulliparous woman who presented with a six-month history of progressive left inguinal swelling. Pelvic magnetic resonance imaging (MRI) identified a left canal of Nuck cyst alongside a constellation of synchronous pelvic pathology, including a serous borderline tumour of the right ovary, a left ovarian cyst, endometriotic deposits on the bladder peritoneum and an anterior uterine wall fibroid. The patient underwent a combined single-stage surgical approach comprising bilateral cystectomy, myomectomy and repair of the inguinal ring defect. This case is notable for the coexistence of a canal of Nuck cyst with multiple independently significant gynaecological diagnoses in a young nulliparous woman. It underscores the importance of a thorough pelvic evaluation when an inguinal swelling is identified, as well as the diagnostic utility of multimodal imaging, given the broad differential diagnosis. This report also highlights the need to consider fertility-sparing surgical approaches in nulliparous women of reproductive age presenting with complex concurrent pelvic pathology.