Going Against the Grain: A Case Report of an Endometriosis in the Canal of Nuck.

Q3 Medicine

European journal of case reports in internal medicine Pub Date : 2024-11-18 eCollection Date: 2024-01-01 DOI:10.12890/2024_005024

Karam Karam, Lamia Azizi, Mehsen Azizi, Emile Dabaj

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引用次数: 0

Abstract

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.

Learning points: 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.

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逆行：努克宫内膜异位1例报告。

Nuck管是在女性中发现的阴道突的胚胎残余，是子宫内膜异位症播种的潜在部位。子宫内膜异位症是一种非常罕见的疾病。此病患者表现为腹股沟肿胀或耻骨上疼痛。我们描述的情况下，44岁的女性提出左侧腹股沟疼痛和肿块。体格检查发现一个3cm的可缩小肿块；磁共振成像（MRI）示6.2 × 3.0 × 1.7 cm多房囊性结构，从左侧骨盆区延伸至左侧腹股沟区圆形韧带附近。病人接受了手术切除肿块。病理显示多囊性病变，内衬间皮细胞和纤维壁，有多灶错位的子宫内膜腺和间质，证实了Nuck管子宫内膜异位症的诊断。学习要点：由于医学文献中缺乏可用的数据，Nuck管子宫内膜异位症是一种极其罕见的病理生理不确定的实体。当接近慢性盆腔疼痛患者时，医生应将Nuck管子宫内膜异位症作为鉴别诊断。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European journal of case reports in internal medicine

CiteScore

2.10

自引率

0.00%

发文量

166

审稿时长

8 weeks

期刊介绍： The European Journal of Case Reports in Internal Medicine is an official journal of the European Federation of Internal Medicine (EFIM), representing 35 national societies from 33 European countries. The Journal''s mission is to promote the best medical practice and innovation in the field of acute and general medicine. It also provides a forum for internal medicine doctors where they can share new approaches with the aim of improving diagnostic and clinical skills in this field. EJCRIM welcomes high-quality case reports describing unusual or complex cases that an internist may encounter in everyday practice. The cases should either demonstrate the appropriateness of a diagnostic/therapeutic approach, describe a new procedure or maneuver, or show unusual manifestations of a disease or unexpected reactions. The Journal only accepts and publishes those case reports whose learning points provide new insight and/or contribute to advancing medical knowledge both in terms of diagnostics and therapeutic approaches. Case reports of medical errors, therefore, are also welcome as long as they provide innovative measures on how to prevent them in the current practice (Instructive Errors). The Journal may also consider brief and reasoned reports on issues relevant to the practice of Internal Medicine, as well as Abstracts submitted to the scientific meetings of acknowledged medical societies.