The Groin Endometriosis: A Great Mimicker of Common Groin Conditions

Abstract

Background:

Inguinal endometriosis occurs in 0.3% to 0.6% of patients affected by endometriosis, it is a rare involvement of the extraperitoneal portion of the round ligament. It is often confused with other inguinal pathology and mostly diagnosed on histological examination. In this study, we report an unusual case of endometriosis in the right inguinal subcutaneous region.

Case:

This case is a 25-year-old woman with 2-year history of painful persistent mass in the right groin and her symptoms fluctuated with the menstrual cycle. On examination, a 3 × 2 cm poorly defined, hard, tender, fixed, irreducible mass without any impulse on coughing was noted and a provisional diagnosis of either an incarcerated inguinal hernia, femoral hernia, or an enlarged inguinal lymph node was made. Magnetic resonance imaging showed 2.7 × 1.7 × 1.6 cm heterogeneous nodular lesion in the right inguinal subcutaneous plane superficial to the adductor muscles and at the lower edge of the rectus abdominis muscle, and fine-needle aspiration cytology from the mass showed the possibility of intramuscular endometriosis.

Result:

We performed an excision of the lesion and the histopathological report showed endometriosis. The patient was symptom free on subsequent follow-up.

Conclusion:

In women of reproductive age with painful groin lesions, a differential diagnosis of endometriosis should be considered. Wide surgical excision of the lesion is usually curative whereby the chances of developing malignancy also diminish. Therefore, timely diagnosis and optimal management of this condition can have high success rates.