International journal of surgery case reports · 2026
Right inguinal canal endometriosis mimicking a groin mass: a rare case report of round-ligament involvement.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Abdallah Rawan, Attieh Philippe, Rizk Nour, Kanso Hani, El Jamal Khaled, Boustany Georges
Аннотация
INTRODUCTION AND IMPORTANCE: Endometriosis is a chronic, estrogen-dependent disorder affecting over 10% of women, but extrapelvic involvement - particularly within the inguinal canal and round ligament - is rare and often mimics common groin pathologies, leading to diagnostic delays when cyclical symptoms are absent.
CASE PRESENTATION: A 31-year-old nulliparous woman presented with a gradually enlarging, painful right inguinal mass over 4 months. She had regular menses and no pelvic symptoms or prior abdominal or gynecologic surgery. Examination revealed a firm, non-tender mass without cough impulse. Pelvic MRI demonstrated an irregular nodular lesion within the right inguinal canal with T2 hypointensity, a small hemorrhagic focus, and progressive contrast enhancement, suggestive of endometriosis. Open surgical exploration identified a mass adherent to the round ligament and canal floor, which was completely excised, followed by mesh-reinforced repair. Histopathology confirmed ectopic endometrial glands and stroma consistent with round-ligament endometriosis. Postoperative recovery was uneventful.
CLINICAL DISCUSSION: Inguinal endometriosis should be considered in reproductive-age women with unexplained groin masses, even without cyclical symptoms or known pelvic disease. MRI provides valuable diagnostic clues, particularly fibrotic T2-hypointense tissue with hemorrhagic elements. Complete excision is both diagnostic and therapeutic, and mesh reinforcement may reduce recurrence.
CONCLUSION: This case highlights the importance of considering inguinal endometriosis in women presenting with groin masses. Early recognition supported by MRI and complete surgical excision ensures accurate diagnosis and excellent outcomes.
CASE PRESENTATION: A 31-year-old nulliparous woman presented with a gradually enlarging, painful right inguinal mass over 4 months. She had regular menses and no pelvic symptoms or prior abdominal or gynecologic surgery. Examination revealed a firm, non-tender mass without cough impulse. Pelvic MRI demonstrated an irregular nodular lesion within the right inguinal canal with T2 hypointensity, a small hemorrhagic focus, and progressive contrast enhancement, suggestive of endometriosis. Open surgical exploration identified a mass adherent to the round ligament and canal floor, which was completely excised, followed by mesh-reinforced repair. Histopathology confirmed ectopic endometrial glands and stroma consistent with round-ligament endometriosis. Postoperative recovery was uneventful.
CLINICAL DISCUSSION: Inguinal endometriosis should be considered in reproductive-age women with unexplained groin masses, even without cyclical symptoms or known pelvic disease. MRI provides valuable diagnostic clues, particularly fibrotic T2-hypointense tissue with hemorrhagic elements. Complete excision is both diagnostic and therapeutic, and mesh reinforcement may reduce recurrence.
CONCLUSION: This case highlights the importance of considering inguinal endometriosis in women presenting with groin masses. Early recognition supported by MRI and complete surgical excision ensures accurate diagnosis and excellent outcomes.