Contemporary Review of Masses in the Canal of Nuck

Abstract

Canal of Nuck masses is a rare occurrence that can cause swelling in the abdominal-inguinal region of females for various reasons. This condition arises due to an abnormal persistence of the processus vaginalis opening. Although Canal of Nuck pathology is not widely known among general surgeons or gynecologists due to its rarity, it has been associated with significant morbidity and requires further research. In this comprehensive review, we aim to summarize the embryology and anatomy of the Canal of Nuck, followed by a description of the various types of masses that can occur in this region. We discuss the clinical presentation and diagnostic workup of Canal of Nuck masses, including imaging modalities and differential diagnoses. Next, we review the surgical management of these masses, including open and laparoscopic approaches. Finally, we discuss the potential complications and long-term outcomes associated with Canal of Nuck pathology. This review aims to compile the presently accessible literature on anomalies occurring in the Canal of Nuck in females, with a particular focus on describing their pathological nature, diagnosis, and management. In summary, this review provides an up-to-date understanding of the pathology, diagnosis, and management of Canal of Nuck masses and aims to raise awareness of this under-recognized surgical challenge among healthcare providers.

Hydrocele of the canal of Nuck: a rare differential diagnosis for an inguinal hernia

“…Ganglion cysts protruding from the hip joint, para-spinal abscesses erupting onto the groin and vascular abnormalities such as hematomas and varicocele are less frequently seen differentials. Varicoceles usually expand during the Valsalva maneuver and are typically seen in pregnant patients at later stages of pregnancy ( 3 , 8 ) .…”

Hidrocele del canal de Nuck

“…Los factores etiológicos responsables son principalmente idiopáticos. Otras causas propuestas son inflamación, traumatismos, alteración del drenaje linfático e hidrocele meconial (5,6) .…”

“…La mayoría de los casos aparecen como una tumefacción irreducible, elástica, indolora o moderadamente dolorosa y elástica en el área inguinal, que puede extenderse hasta los labios mayores. Además, puede ser transiluminada si es suficientemente grande (6) . No obstante, no presenta hallazgos clínicos característicos (2) .…”

“…Los hallazgos ecográficos incluyen la lesión quística de paredes finas, anecoica o hipoecoica, bien definida, que mantiene su tamaño y forma con la maniobra de Valsalva, situada superficialmente en la región inguinal y/o vulvar, con realce acústico posterior y ausencia de vascularización en el Doppler color (12) . En algunos casos pueden observarse septos internos, los cuales han sido descritos como restos de intentos de obliteración espontánea (6) . Las imágenes de resonancia magnética muestran una lesión quística bien definida de paredes finas, que es hiperintensa en T2 e hipointensa en T1 (13) .…”

“…Las linfadenopatías y los tumores de partes blandas (lipomas, fibromas, leiomiomas, sarcomas, neuroma, quiste inguinal, hernias inguinales o femorales, bartholinitis, aneurisma de la arteria femoral y endometriosis del ligamento redondo) pueden causar tumefacciones inguinales y/o vulvares. Las anomalías vasculares, tumores apendiculares o retroperitoneales también pueden producir tumefacción inguinal (6) .…”