Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2021; 9(36): 11406-11418
Published online Dec 26, 2021. doi: 10.12998/wjcc.v9.i36.11406
Inguinal endometriosis: Ten case reports and review of literature
Shu-Hong Li, Heng-Zi Sun, Wei-Hua Li, Shu-Zhen Wang
Shu-Hong Li, Heng-Zi Sun, Wei-Hua Li, Shu-Zhen Wang, Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
Author contributions: Li SH performed the conception and design; Li SH and Wang SZ performed the administrative support; Li SH and Sun HZ performed the provision of study materials or patients; Sun HZ and Li WH performed the collection and assembly of data; Sun HZ performed the data analysis and interpretation; all authors contribute to manuscript writing and final approval of manuscript.
Supported by 2017 "Sailing" Plan of Beijing, No. ZYLX201713.
Informed consent statement: Written informed consent was obtained from the patients for publication of this case report and accompanying images and clinical data.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shu-Zhen Wang, PhD, Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongrentiyuchang Nan Road, Chaoyang District, Beijing 100020, China. wangshuzhen_gyn@163.com
Received: June 22, 2021
Peer-review started: June 22, 2021
First decision: September 1, 2021
Revised: September 29, 2021
Accepted: November 15, 2021
Article in press: November 15, 2021
Published online: December 26, 2021
Processing time: 184 Days and 3.4 Hours
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.