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Korean Journal of Obstetrics & Gynecology 2008;51(12):1533-1538.
Published online December 1, 2008.
Inguinal endometriosis connected to intraperitoneal round ligament: Complete excision with extraperitoneal wide dissection.
Myong Cheol Lim, Ji Young Choi, Dong Ock Lee, Jong Woo Yoo, Sang Yoon Park, Sang Soo Seo
1Center for Uterine Cancer, National Cancer Center, Goyang, Korea. ssseomd@ncc.re.kr
2Department of Obstetrics and Gynecology, Kyunghee University College of Medicine, Seoul, Korea.
3Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Inguinal endometriosis is a rare gynecologic disease. A 43-year-old woman had felt small nodular mass, which causing cyclic groin pain and fluctuation with menstrual cycle. CT scan revealed the extraperitoneal inguinal mass connected to the left round ligament. During the operation, infiltrative fibrotic mass around the inguinal mass could only be excised with wide groin dissection. After dissection of the abdominal muscles, the intraperitoneal mass could be pulled out and excised at the level of the intact round ligament. Histological diagnosis at the excised mass was endometriosis. After the surgery, the pain disappeared completely. We have reviewed published articles concerning inguinal endometriosis. The mechanism of development of inguinal endometriosis seems to be to that of indirect hernia with a difference of disappearing hernia sac resulting from inflammation of endometriosis. About half of the patients revealed periodicity such as cyclic pain or fluctuation of pain with menstral cycle. We describe the complete surgical excision of extraperitoneal inguinal endometriosis connected to round ligament endometriosis. Successful treatment can be achieved with understanding of the pathophysiology and anatomy related to the inguinal endometriosis.
Key Words: Endometriosis, Round ligament, Groin, Tumor, Surgery
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