Right-Sided Inguinal Pain in Isolated Inguinal Endometriosis

We report the case of a 32-year-old female patient with a 3-month history of swelling of the right groin and recurrent menstrual cycle-dependent pain. Clinically, a 1-cm induration that was painful on palpation but without infection parameters was found. With the exception of an open appendectomy in 2000, the patient’s history was unremarkable. The gynecological history and examination, which included ultrasound, yielded no diagnostic findings. The pelvic MRI that was performed showed a poorly defined, 2.4 × 1.3-cm soft-tissue mass in the right inguinal canal with homogeneous contrast enhancement and dot-like signal enhancement in the fat-suppressed sequence, as well as reactive locoregional lymphadenopathy. In view of the unremarkable presentation of the other pelvic organs, isolated inguinal endometriosis was suspected and subsequently confirmed histologically following surgical excision. Inguinal endometriosis is a rare occurrence in endometriosis patients (0.6–0.8%) and is congenitally located on the right side in 90% of cases. Isolated inquinal endometriosis in the context of an initial manifestation is extremely rare, and only a handful of case studies have been published.

Figure

MRI of the pelvis

Dr. med. Stefan Fischer, Asklepios Klinikum Harburg, Klinik für Diagnostische und Interventionelle Radiologie, Neuroradiologie, [e-mail]

Dr. med. Daniel Seemann, Asklepios Klinikum Harburg, Klinik für Allgemein- und Viszeralchirurgie

Dr. med. Hanns-Olof Wintzer, MVZ Hanse Histologikum, Hamburg

Conflict of interest statement: The authors state that no conflict of interest exists.

Translated from the original German by Christine Rye.

Cite this as: Fischer S, Seemann D, Wintzer HO: Right-sided inguinal pain in isolated inguinal endometriosis. Dtsch Arztebl Int 2022; 119: 762. DOI: 10.3238/arztebl.m2022.0113