Inguinal endometriosis - a series of five cases and literature review

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Abstract

Introduction:

Endometriosis is a benign gynecological pathology defined as the presence of ectopic endometrial tissue which grows in response to hormonal stimulus. It affects women of reproductive age, with a prevalence of 10%-20%. Although it appears mainly in the pelvic organs, we can find lesions in extrapelvic locations. Inguinal endometriosis is a very rare event. A history of painful inguinal mass, with exacerbation related to the menstrual cycle is the hallmark of diagnosis. However, typical symptoms may not be present or can mimic other inguinal pathology, posing a diagnostic challenge. In this article we present five cases of inguinal endometriosis referred to our institution along with a brief review of literature.

Case report:

We describe five clinical cases of women with inguinal endometriosis. Four of these cases were initially referred to general surgery and two of them had a primary diagnosis of inguinal hernia. Three patients were submitted to biopsy, which established the diagnosis of endometriosis prior to surgery in all. Surgical excision of the lesion was performed in all but one patient who refused treatment, and there were no serious complications or recurrences.

Discussion:

Inguinal endometriosis is a rare condition. To diagnose this situation, physicians need to be aware of this pathology and include it in the differential diagnosis when facing a child-bearing age woman with complains of painful inguinal mass. Although the definitive diagnosis is histological, ultrasound or MRI may be helpful to establish a presumptive diagnosis. Surgical excision is the treatment of choice and is, in general, definitive.

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