Inguinal endometriosis: Ten case reports and review of literature

Abstract

BACKGROUND

To describe the characteristics, diagnosis and surgical treatment of inguinal endometriosis (IEM).

CASE SUMMARY

We retrospectively analyzed 10 patients diagnosed with IEM at Beijing Chao-Yang Hospital from 2011 to 2019. Relevant features, symptoms, images, surgical treatment, hormonal therapy and follow-up were collected and discussed. A total of 10 cases of IEM diagnosed by surgery and pathology were characterized by a lesion on the right side (9/11); five patients had symptoms related to the menstrual cycle, and only 3 patients were clearly diagnosed before surgery. Ultrasonography was of little assistance in confirming the diagnosis, but magnetic resonance imaging showed specific, high-intensity patterns. Anatomically, most of the IEM lesions were located in the extraperitoneal ligament (10/11); nine patients had inguinal hernias (IH), five had concurrent or prior pelvic endometriosis, and four had infertility. The clinical results from extensive resection were satisfactory.

CONCLUSION

IEM is an extremely rare condition that can easily be misdiagnosed prior to surgery. A right IH may contribute to the formation of right-sided IEM, and extensive resection involving the round ligament and hernia sac is essential to prevent recurrence.

Keywords: Inguinal endometriosis; Clinical characteristics; Imaging examination; Pelvic endometriosis; Treatment; Case report

Core Tip: An inguinal hernia on the right side may be one of the causes of the formation of right inguinal endometriosis. This condition may present clinically as a painful mass that can vary in size, possibly according to menstrual cyclicity. Preoperative imaging using ultrasound and/or magnetic resonance imaging may be useful for preoperative diagnosis. Extensive resection involving the round ligament and hernia sac is necessary to prevent recurrence.