European journal of case reports in internal medicine最新文献

{"title":"Coexistence of Vascular Ehlers-Danlos Syndrome and Sticky Platelet Syndrome: A Lethal Combination in A Young Patient with Thrombophilia and Haemorrhagic Diathesis.","authors":"Manuel De Miguel-Escribano, Manuel Garrido-Montes, Pablo Astudillo-Ortega, Roberto Pertusa-Mataix, Andrea Rodríguez-Trigueros, Jorge Corchero-Gijón, Jose-Salvador Garcia-Morillo","doi":"10.12890/2024_005018","DOIUrl":"10.12890/2024_005018","url":null,"abstract":"<p><strong>Background: </strong>The coexistence of hypercoagulability and bleeding diathesis in the same patient represents a potentially lethal combination due to its complex management. Vascular Ehlers-Danlos syndrome (vEDS) and sticky platelet syndrome (SPS) are classified as rare diseases due to their low prevalence. vEDS is associated with bleeding tendencies caused by vascular wall fragility, while SPS is characterized by atypical arterial and venous thrombosis.</p><p><strong>Case report: </strong>We report a 27-year-old woman, smoker and regular consumer of energy drinks, with a medical history of subclinical hypothyroidism, minor thalassemia, recurrent joint sprains, high myopia, and anterior mitral valve prolapse, who was diagnosed with both vEDS and SPS type I. The patient experienced a catastrophic progression over a short time period, marked by numerous thrombotic and bleeding episodes, ultimately leading to a fatal outcome.</p><p><strong>Conclusions: </strong>This report documents the first known case of concurrent vEDS and SPS, highlighting the complexity and challenges in the management of these two rare conditions together. The interplay between these syndromes necessitates careful clinical consideration and the development of tailored management strategies to mitigate associated risks. This underscores the crucial role of the internist in overseeing such cases. Further studies are needed to explore new therapeutic strategies aimed at improving survival rates and outcomes for patients with this unique combination of disorders.</p><p><strong>Learning points: </strong>The coexistence of vascular Ehlers-Danlos syndrome (vEDS) and sticky platelet syndrome (SPS) creates a unique clinical scenario where the underlying connective tissue weakness and platelet hyperaggregability synergistically increase the risk of both thrombotic and haemorrhagic events, complicating management strategies.Internists must assume a pivotal role in the integrated management of patients with vEDS and SPS, facilitating a multidisciplinary strategy that not only addresses the dual risk of thromboembolic and haemorrhagic complications but also emphasizes the importance of personalized treatment algorithms and ongoing surveillance to optimize long-term outcomes.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"11 12","pages":"005018"},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Cutaneous Toxicity in A 67-Year-Old Patient with Metastatic Urothelial Carcinoma Undergoing Therapy with Enfortumab Vedotin and Pembrolizumab.","authors":"Benjamin Müller, Riccardo Curatolo, Hazem A Juratli, Almir Husic, Josephine Nehring, Eliska Potlukova, Angela Kohler","doi":"10.12890/2024_005003","DOIUrl":"10.12890/2024_005003","url":null,"abstract":"<p><strong>Introduction: </strong>Enfortumab vedotin (EV) combined with pembrolizumab (EV+P) is a promising first-line therapy for metastatic urothelial carcinoma. While it has shown significant efficacy, severe cutaneous adverse events such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) have been reported. We present this case as another example of severe skin off-target toxicity associated with this treatment, emphasising the importance of recognising this potential complication.</p><p><strong>Case description: </strong>A 67-year-old male with metastatic urothelial carcinoma, chronic kidney failure and liver cirrhosis presented with fever, respiratory symptoms and a pruritic rash after two doses of EV+P. The rash rapidly worsened, leading to extensive skin desquamation affecting 20-30% of his body surface area. Skin biopsies confirmed SJS with early-stage TEN (SJS/TEN overlap). The patient was treated with high-dose intravenous steroids, empirical antibiotics for neutropenia and intensive topical care. Significant re-epithelialisation occurred by day 13, and the patient was discharged on day 15 with cessation of EV+P therapy.</p><p><strong>Conclusion: </strong>This case demonstrates the potential for severe cutaneous toxicity in patients receiving EV+P, especially those with complex comorbidities. Early recognition and prompt, aggressive management with systemic corticosteroids are essential for improving outcomes. The case highlights the need for vigilance in monitoring for such adverse events and reporting them to improve patient safety.</p><p><strong>Learning points: </strong><b>High clinical suspicion</b> recognition of early signs of dermolysis is essential in managing severe cutaneous toxicity associated with enfortumab vedotin.<b>A multidisciplinary approach</b> the management of Stevens-Johnson syndrome/toxic epidermal necrolysis should involve a multidisciplinary team, especially in patients with complex comorbidities.<b>Pharmacovigilance</b> continuous monitoring and prompt reporting of adverse events to health authorities are vital for improving patient safety and therapeutic outcomes.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"11 12","pages":"005003"},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic Endometriosis Syndrome in a 75-Year-Old Woman.","authors":"Amritpal S Jagra, Ruhma Ali, Alan Klukowicz, Hari Sharma, Richard Miller","doi":"10.12890/2024_004919","DOIUrl":"10.12890/2024_004919","url":null,"abstract":"<p><p>Thoracic endometriosis syndrome (TES) is a rare condition where endometrial tissue is found in the pleura, parenchyma, and/or diaphragm. Haemoptysis is a common manifestation of pulmonary endometriosis and can be cyclic, aligning with the menstrual cycle. Patients can present with residual cough once menses have stopped. Other manifestations are recurrent pneumothorax and/or pleural effusions associated with menses. On imaging, pulmonary nodules or implants of endometrial tissue along the diaphragm can be present and be confirmed by biopsy. While most cases of TES occur in menstruating females in their thirties on the right side, our case is unique since we report a postmenopausal female with TES on the left side without the typical clinical manifestations.</p><p><strong>Learning points: </strong>Physician awareness about thoracic endometriosis appearing as a lung mass on the left side in a postmenopausal woman is essential to aid in prompt diagnosis and management of this rare pathology.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"11 12","pages":"004919"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Posterior Cranial Fossa Lesion Mimicking Myasthenia Gravis.","authors":"Syed Wajihullah Shah, Maryam Khalil, Mansoor Iqbal, Arham Arif Kundi, Muhammad Hassaan","doi":"10.12890/2024_005032","DOIUrl":"10.12890/2024_005032","url":null,"abstract":"<p><p>A 41-year-old male with prior diagnosis of seronegative myasthenia gravis presented with complaints of bilateral ptosis, dysphagia, nasal voice and nasal regurgitation. Despite treatment with pyridostigmine, there was lack of significant improvement in the symptoms. Further investigations, including antibody assays and nerve conduction studies did not support the diagnosis. Magnetic resonance imaging revealed a lesion in the posterior cranial fossa, consistent with meningioma, which was compressing surrounding structures. This case highlights the importance of imaging techniques and considering alternative diagnosis in patients with unusual presentations to ensure appropriate management.</p><p><strong>Learning points: </strong>This case emphasizes the importance of imaging in patients presenting with symptoms similar to those of neuromuscular junction disorders.It also highlights the possible challenges in diagnosis of such patients.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"11 12","pages":"005032"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dizziness, Light-Headedness or A Clot-In-Transit: Obtaining a History and Physical Examination is Both a Science and an Art.","authors":"Abhinav Hoskote, Shreya Sudadi, Brent Dembo, Michelle Consolini, Rahul Kashyap","doi":"10.12890/2024_005031","DOIUrl":"10.12890/2024_005031","url":null,"abstract":"<p><strong>Introduction: </strong>Venous thromboembolism (VTE) rarely presents with dizziness as the primary complaint, which can delay diagnosis. We report a rare case of dizziness as the chief complaint for a clot-in-transit and extensive bilateral pulmonary emboli.</p><p><strong>Case description: </strong>A 70-year-old woman presented to the emergency room (ER) with dizziness and a fall, without reporting loss of consciousness. Her symptoms included positional dizziness, tinnitus and visual darkness, alongside prior exertional fatigue and dull chest pressure. Despite a history of left leg oedema and inconsistent use of medications for hypertension and diabetes, initial examinations suggested vestibular neuritis and decompensated heart failure, confirmed by echocardiogram findings and response to prednisone. While hospitalised, she experienced pre-syncope after showering, initially deemed vasovagal. However, exertional hypotension led to further investigation, revealing right heart strain. Ultrasound identified a left popliteal deep vein thrombosis, and a computed tomography (CT) angiogram confirmed extensive bilateral pulmonary emboli with right heart strain. Cardiology discovered large, mobile thrombi in transit in the heart, necessitating an urgent mechanical thrombectomy. Following treatment, her pulmonary pressure improved, and she was discharged on anticoagulation medicine. One month later, an echocardiogram showed normalised heart function.</p><p><strong>Conclusion: </strong>This case highlights the importance of differentiating dizziness from pre-syncope, as exertional pre-syncope can indicate an obstructive physiology such as VTE. Cognitive bias can obscure diagnosis in atypical presentations. A pulmonary embolism response team could improve management of these cases, where prompt diagnosis and treatment are essential for favourable outcomes.</p><p><strong>Learning points: </strong>Cognitive bias should be consistently challenged while ruling out pulmonary emboli based on the absence of typical signs.It is essential to differentiate vertigo from light-headedness or pre-syncope in patients presenting with a complaint of dizziness.Pre-syncope can be an important presenting complaint of haemodynamically significant pulmonary emboli and clots in transit.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"11 12","pages":"005031"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Arteriovenous Malformation: Not all Hypoxemia During Covid-19 is the Same.","authors":"Ramitha Ramachandran, Anuroop Balagopal, Nilanjan Umesh, Manjush Karthika","doi":"10.12890/2024_005027","DOIUrl":"10.12890/2024_005027","url":null,"abstract":"<p><p>Hypoxemia in coronavirus disease 2019 (COVID-19) patients is not solely due to alveolar damage but can also involve factors like vascular shunts, such as pulmonary arteriovenous malformation, contributing to persistent hypoxemia. We report a case of a 59-year-old male, with COVID-19 pneumonia, requiring high-flow respiratory support, who later was also diagnosed with a large pulmonary arteriovenous fistula, which probably worsened because of COVID-19 infection.</p><p><strong>Learning points: </strong>Hypoxemia in coronavirus disease 2019 (COVID-19) patients is multifaceted not only with alveolar damage but also with other factors such as vascular shunts, like pulmonary arteriovenous malformation.Diagnosing pulmonary arteriovenous malformation can be difficult due to overlapping symptoms with other respiratory disorders.Management of pulmonary arteriovenous malformation typically involves transcatheter embolization to block abnormal vascular connections and reduce the risk of complications like paradoxical emboli. Surgical options are reserved for severe cases, while pharmacological treatments are less common.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"11 12","pages":"005027"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-LGI1 Autoimmune Limbic Encephalitis: An Easy-To-Miss Diagnosis.","authors":"Carolina Freitas Henriques, Rui Fernandes, Leonor Neves, Rubina Miranda, Duarte Noronha, Teresa Carolina Aguiar, Teresa Faria","doi":"10.12890/2024_005025","DOIUrl":"10.12890/2024_005025","url":null,"abstract":"<p><strong>Background: </strong>Autoimmune limbic encephalitis (ALE) is a rare inflammatory disorder characterised by a subacute onset, usually within weeks. The presence of multiple neuropsychiatric symptoms such as seizures, short-term memory deficits, anxiety and depression often leads to misdiagnosis as another medical condition, contributing to poor prognosis and reduced long-term survival.</p><p><strong>Case description: </strong>A 60-year-old man, with no chronic illnesses, presented at the emergency department with daily episodes of palpitations, shivering, piloerection and a sense of impending doom lasting two months. Initially diagnosed with anxiety disorder and treated with venlafaxine 50 mg daily, he showed no improvement and developed memory loss. Hospitalised three months later, he exhibited both temporal and spatial disorientation, along with short-term memory loss. Key findings included elevated serum sedimentation rate, hyponatraemia, increased cerebrospinal fluid (CSF) protein levels and cranial magnetic resonance imaging evidence of bilateral temporal intra-parenchymal lesions, suggesting limbic encephalitis. After ruling out alternative diagnoses, screening of autoantibodies in the CSF was requested, which was positive for anti-LGI1 antibodies. The diagnosis of anti-LGI1 ALE was assumed, and treatment was initiated with significant clinical and imaging improvement.</p><p><strong>Conclusions: </strong>ALE's broad clinical spectrum contributes to underdiagnosis. Therefore, in patients with new onset of neuropsychiatric symptoms and no prior psychiatric history, ALE should be considered, as prompt diagnosis and treatment are pivotal to achieve a good prognosis.</p><p><strong>Learning points: </strong>Autoimmune limbic encephalitis is a rare inflammatory neurological disease that affects the limbic system particularly the hippocampus, leading to memory impairment and neuropsychiatric symptoms.Due to its wide range of neuropsychiatric symptoms, the diagnosis of autoimmune limbic encephalitis may go unnoticed, leading to misdiagnosis as another medical disorder.Early diagnosis is essential to prevent potential neurological sequelae through appropriate treatment.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"11 12","pages":"005025"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Persistence of Inappropriate Antidiuretic Hormone Secretion Following Minor Head Injury.","authors":"Pierre Rossignon, Abouzar Chaudhry, Mounia Alloum, Thomas Antoine-Moussiaux, Alain Soupart","doi":"10.12890/2024_005028","DOIUrl":"10.12890/2024_005028","url":null,"abstract":"<p><p>The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a common cause of euvolemic hyponatremia, resulting from non-osmotic release of antidiuretic hormone (ADH). SIADH is frequently associated with neurological conditions, including traumatic brain injury (TBI). TBI-associated SIADH usually develops within days to weeks and resolves within a few weeks. We present the case of a 74-year-old man who, after a fall resulting in TBI, initially had normal sodium levels. Fifteen days later, he developed moderate-to-severe hyponatremia (120 mmol/l) and significant neurological symptoms. Treatment with urea effectively normalized his sodium levels and resolved symptoms. However, recurrent hyponatremia persisted for over six months whenever urea treatment was discontinued. This unusual duration of TBI-associated SIADH underscores the importance of long-term follow-up in the management of post-traumatic hyponatremia.</p><p><strong>Learning points: </strong>While the syndrome of inappropriate antidiuretic hormone secretion (SIADH) is typically transient, it can persist after even minor head trauma, highlighting the importance of long-term follow-up in cases of post-traumatic hyponatremia.Urea therapy is effective and well-tolerated for managing chronic hyponatremia in SIADH, offering a sustainable long-term treatment option.Even mild hyponatremia can lead to subtle but impactful cognitive and motor symptoms.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"11 12","pages":"005028"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haemophagocytic Lymphohistiocytosis Triggered by Cytomegalovirus Reactivation in An Immunosuppressed Patient with Pauci-Immune Glomerulonephritis.","authors":"Léa Docquier, Ishak Beklevic, Serge Treille de Grandseigne, Benoit Guillaume, Aline Pourcelet","doi":"10.12890/2024_004847","DOIUrl":"10.12890/2024_004847","url":null,"abstract":"<p><p>We report on a 67-year-old male patient admitted to the Internal Medicine department for fever, joint pain and exertional dyspnoea. Two months before his admission, the patient had been diagnosed with pauci-immune necrotising glomerulonephritis, for which he had been treated with rituximab and corticosteroids. Upon admission the patient was stable, but within a few hours he became unstable as liver failure and acute cytopaenia occurred. Blood investigations revealed cytopaenia, altered coagulation tests, high ferritin, triglycerides, lactate dehydrogenase and C-reactive protein levels, and severe cytocholestasis. A liver echography was normal. The patient had been transferred to the intensive care unit to receive supportive support when the cytomegalovirus polymerase chain reaction (CMV-PCR) test came back positive. The diagnosis of haemophagocytic lymphohistiocytosis associated with a CMV infection and/or reactivation in an immunosuppressed patient was made. Specific treatment was administrated, along with symptomatic treatment. The patient clinically improved during hospitalisation with complete resolution of symptoms.</p><p><strong>Learning points: </strong>Haemophagocytic lymphohistiocytosis (HLH) is a rare disease yet important to diagnose, as it is quickly life-threatening.The diverse symptoms of HLH can make diagnosis tricky, with many potential causes. As clinical presentation is not very specific, it is often mistaken for infection with severe sepsis and its diagnosis is often delayed.Limited understanding of this condition could lead to worse outcomes for patients. Recognising it early is crucial for starting the right treatment and enhancing both the well-being and survival chances of those affected by this complex disorder.In practice, HLH must be suspected when bi/pancytopaenia occurs in a patient presenting a high fever of unknown cause, especially when they have a history of immunosuppression. Managing it often requires a range of approaches, such as intensive care, immune system suppression, specialised medications or even stem cell transplants.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"11 12","pages":"004847"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Going Against the Grain: A Case Report of an Endometriosis in the Canal of Nuck.","authors":"Karam Karam, Lamia Azizi, Mehsen Azizi, Emile Dabaj","doi":"10.12890/2024_005024","DOIUrl":"10.12890/2024_005024","url":null,"abstract":"<p><p>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.</p><p><strong>Learning points: </strong>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.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"11 12","pages":"005024"},"PeriodicalIF":0.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}