Karam Karam, Azizi Lamia, Azizi Mehsen, Dabaj Emile
Department of Gastroenterology, University of Balamand, Beirut, Lebanon.
Department of Radiology, University of Balamand, Beirut, Lebanon.
Eur J Case Rep Intern Med. 2024 Nov 18;11(12):005024. doi: 10.12890/2024_005024. eCollection 2024.
The canal of Nuck is an embryological remnant of the processus vaginalis found in females, and is a potential site for endometriosis seeding. Endometriosis in the canal of Nuck is an exceedingly rare condition. Patients with this condition present with groin swelling or suprapubic pain. We describe a case of a 44-year-old female presenting for left inguinal pain and a lump. Physical examination revealed a 3 cm reducible mass; magnetic resonance imaging (MRI) revealed a 6.2 × 3.0 × 1.7 cm multiloculated cystic structure, extending from the left pelvic region into the left inguinal region near the round ligament. The patient underwent surgical excision of the mass. Pathology revealed a multi-cystic lesion lined with mesothelium cells and a fibrous wall with multiple foci of misplaced endometrial glands and stroma, corroborating a diagnosis of endometriosis in the canal of Nuck.
Endometriosis of the canal of Nuck is an exceedingly rare entity with an uncertain pathophysiology due to paucity of data available in the medical literature.Physicians should keep Nuck's canal endometriosis in their differential diagnosis when approaching a patient with chronic pelvic pain.
Nuck管是女性阴道突的胚胎学残余物，是子宫内膜异位症种植的潜在部位。Nuck管内的子宫内膜异位症极为罕见。患有这种疾病的患者表现为腹股沟肿胀或耻骨上疼痛。我们描述了一例44岁女性因左腹股沟疼痛和肿块就诊的病例。体格检查发现一个3厘米可复性肿块；磁共振成像（MRI）显示一个6.2×3.0×1.7厘米的多房囊性结构，从左盆腔区域延伸至左腹股沟区域靠近圆韧带处。患者接受了肿块的手术切除。病理显示一个内衬间皮细胞的多囊性病变和一个有多处异位子宫内膜腺体和间质灶的纤维壁，证实为Nuck管内子宫内膜异位症的诊断。
由于医学文献中可用数据匮乏，Nuck管内的子宫内膜异位症是一种极为罕见的实体，其病理生理学尚不确定。当接诊慢性盆腔疼痛患者时，医生应将Nuck管内子宫内膜异位症纳入鉴别诊断。
