Hagiwara Y, Hatori M, Moriya T, Terada Y, Yaegashi N, Ehara S, Kokubun S
Departments of Orthopedic Surgery, Tohoku University School of Medicine, Sendai, Japan.
Australas Radiol. 2007 Feb;51(1):91-4. doi: 10.1111/j.1440-1673.2006.01667.x.
We report a case of endometriosis in the right inguinal region, attached to the right round ligament in a 28-year-old woman. At the age of 20, laparoscopic left ovarian cystectomy and pelvic adhesiolysis for endometriosis was carried out. She noticed a right tender groin mass 7 months previously, and the tumour size fluctuated with the menstrual cycle. A poorly circumscribed elastic hard mass, measuring 3 cm in diameter, was palpated in her right inguinal region. Magnetic resonance imaging showed a 2.5 cm x 2.5 cm mass in the right inguinal canal and a 5.4 cm x 6.8 cm mass was seen in the left ovary. The mass enlarged during menstruation. The groin mass was removed, in addition to carrying out laparoscopic ovarian cystectomy. At operation, the groin mass was found to be in continuity with the round ligament of extraperitoneal portion. Histological diagnosis of endometriosis was made in both ovarian and inguinal tumours. After surgery, the pain disappeared completely. Worth mentioning is that MRI clearly showed the change of tumour size depending on the menstrual cycle, which aided in arriving at the correct diagnosis of endometriosis in an unusual location.
我们报告一例28岁女性右腹股沟区子宫内膜异位症，病灶附着于右圆韧带。患者20岁时因子宫内膜异位症接受腹腔镜下左卵巢囊肿切除术及盆腔粘连松解术。7个月前她发现右侧腹股沟区有一触痛性肿块，且肿块大小随月经周期波动。在其右腹股沟区可触及一个边界不清的质地硬且有弹性的肿块，直径3厘米。磁共振成像显示右腹股沟管内有一个2.5厘米×2.5厘米的肿块，左卵巢有一个5.4厘米×6.8厘米的肿块。肿块在月经期间增大。除进行腹腔镜卵巢囊肿切除术外，还切除了腹股沟区肿块。手术中发现腹股沟区肿块与腹膜外部分的圆韧带相连。卵巢和腹股沟区肿瘤的组织学诊断均为子宫内膜异位症。术后疼痛完全消失。值得一提的是，磁共振成像清晰显示了肿瘤大小随月经周期的变化，这有助于对不寻常部位的子宫内膜异位症做出正确诊断。
