Nava Caterina Maria, Geng Benoit, Litchinko Alexis, Jaccard Claudia, Egger Bernhard
Department of Surgery, HFR Fribourg Cantonal Hospital, CH-1708 Fribourg, Switzerland; Department of Pathology, Promed Laboratoire Médical SA, CH-1723 Marly, Switzerland.
Department of Surgery, HFR Fribourg Cantonal Hospital, CH-1708 Fribourg, Switzerland; Department of Pathology, Promed Laboratoire Médical SA, CH-1723 Marly, Switzerland.
Int J Surg Case Rep. 2025 Jan;126:110807. doi: 10.1016/j.ijscr.2024.110807. Epub 2024 Dec 31.
The cyst of the canal of Nuck is a rare cause of inguino-labial swelling in adult women, arising from an obliteration failure of the processus vaginalis during embryological development. Its rarity often leads to misdiagnosis and improper treatment. This article highlights its diagnosis and surgical management.
A 21-year-old woman presented with a two-month history of symptomatic swelling in the right inguino-labial region, after consulting multiple doctors. Various investigations including abdominal ultrasonography, computed tomography, and Magnetic Resonance Imaging revealed multiloculated cystic lesion with thin walls, without communication to the peritoneal cavity. During surgery, an encysted sack was discovered at the external inguinal ring, with no associated hernia. The cyst was ligated high and excised along with the round ligament. The anatomical defect was repaired without using prosthetic mesh. The patient had an uneventful post-operative recovery at six-months follow-up.
The encysted hydrocele (Type 1) is the most common among the three types of canal of Nuck hydroceles. This rare entity should be considered in the differential diagnosis of groin masses, even in adult women. Ultrasonography is often used initially, while Magnetic Resonance Imaging is reserved for complex cases. Surgical intervention is essential for both diagnosis and treatment, with dissection extending up to the deep inguinal ring to address any associated hernias. The choice between open or laparoscopic procedures depends on the nature of the defect.
Surgery remains the sole standard therapeutic approach for the management of the cyst of the canal of Nuck.
努克管囊肿是成年女性腹股沟阴唇肿胀的罕见原因，它源于胚胎发育过程中鞘突闭锁失败。其罕见性常导致误诊和不恰当的治疗。本文重点介绍其诊断和手术治疗。
一名21岁女性在咨询多位医生后，因右侧腹股沟阴唇区域有两个月的症状性肿胀前来就诊。包括腹部超声、计算机断层扫描和磁共振成像在内的各种检查显示为多房性薄壁囊性病变，与腹腔无连通。手术中，在腹股沟外环处发现一个包囊性囊袋，无相关疝。囊肿高位结扎并连同圆韧带一并切除。未使用人工补片修复解剖缺陷。患者在六个月的随访中术后恢复顺利。
包囊性鞘膜积液（1型）是努克管鞘膜积液三种类型中最常见的。即使在成年女性中，在腹股沟肿块的鉴别诊断中也应考虑这种罕见疾病。通常首先使用超声检查，而磁共振成像则用于复杂病例。手术干预对诊断和治疗都至关重要，解剖应延伸至腹股沟深环以处理任何相关疝。开放手术或腹腔镜手术的选择取决于缺陷的性质。
手术仍然是治疗努克管囊肿的唯一标准治疗方法。
