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.

Laparoscopic surgery for endometriosis of the round ligament: A case of a patient with right-sided inguinal pain

“…Additional symptoms may include dysmenorrhea, lower abdominal pain, discomfort in the suprapubic region, and infertility. 10 – 12 In our case, the patient did not mention any development or alteration in the size of the groin, and there was no detectable mass during the physical examination. However, the patient exhibited slight tenderness upon deep palpation and reported experiencing intense, persistent pain in the right inguinal area during menstruation and catamenial symptoms.…”

“… 25 MRI is the most specific and sensitive imaging modality to diagnose inguinal endometriosis, as it is able to detect iron in hemosiderin deposits in endometrioma. 12 …”

Differential diagnoses of inguinal swellings: a case series of atypical diagnoses

“…The groin area is a rare site of endometriosis, with a frequency of 0.3–0.6% of all endometriosis patients [ 11 ]. The etiology of inguinal endometriosis is unclear, and it can be easily misdiagnosed as it often coexists with an inguinal hernia [ 12 ].…”

A case report of Inguinal Endometriosis-A rare entity of a common condition

“…Catamenial symptoms such as increased size, tenderness, and pain, should increase the index of suspicion of IEM (8). High-resolution ultrasonography is a low-cost and reliable method for establishing the suspicion of an IEM diagnosis (9).…”