Citation, DOI, disclosures and article data
Citation:
Weerakkody Y, Amer M, Knipe H, et al. Inguinal endometriosis. Reference article, Radiopaedia.org (Accessed on 19 Apr 2024) https://doi.org/10.53347/rID-53148
Inguinal endometriosis is an unusual extrapelvic site for endometriosis.
The estimated incidence is <0.1% among those having endometriosis 4. There is an increased right-sided predilection (~85% of reported cases) 9.
Patients may present with a tender groin mass that fluctuates with the menstrual cycle. Concomitant pelvic endometriosis may be present.
As with endometriosis in general it is characterized by the presence of endometrial glands and stroma in the inguinal region. Direct extension of endometrial tissue along the round ligament is considered a possible pathogenesis.
Ultrasound
A mass or cluster of masses of variable size and shape in the inguinal region is demonstrated. They may be solid, cystic or have a combination 9.
MRI
Typically signal characteristics are similar to endometriosis elsewhere. But in a proportion of cases of inguinal endometriosis, MRI features can be atypical and non-specific, e.g. intermediate or high signal intensity on T2- weighted images.
MRI may show better anatomical delineation as well as contiguity with the round ligament.
Treatment and prognosis
Surgery is usually considered the treatment of choice 5. In those considered for surgical resection, excision of the extraperitoneal portion of the round ligament is also recommended 7.
Clinically, it may be misdiagnosed as an inguinal hernia 5.
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1. Hagiwara Y, Hatori M, Moriya T et al. Inguinal Endometriosis Attaching to the Round Ligament. Australas Radiol. 2007;51(1):91-4. doi:10.1111/j.1440-1673.2006.01667.x - Pubmed
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2. Tokue H, Tsushima Y, Endo K. Magnetic Resonance Imaging Findings of Extrapelvic Endometriosis of the Round Ligament. Jpn J Radiol. 2009;27(1):45-7. doi:10.1007/s11604-008-0293-0 - Pubmed
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3. Licheri S, Pisano G, Erdas E et al. Endometriosis of the Round Ligament: Description of a Clinical Case and Review of the Literature. Hernia. 2005;9(3):294-7. doi:10.1007/s10029-004-0314-6 - Pubmed
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4. Sun Z, Zhu L, Lang J. A Rare Extrapelvic Endometriosis: Inguinal Endometriosis. J Reprod Med. 2010;55(1-2):62-6. - Pubmed
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5. Apostolidis S, Michalopoulos A, Papavramidis T, Papadopoulos V, Paramythiotis D, Harlaftis N. Inguinal Endometriosis: Three Cases and Literature Review. South Med J. 2009;102(2):206-7. doi:10.1097/SMJ.0b013e318186d36e - Pubmed
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6. Kapan M, Kapan S, Durgun A, Goksoy E. Inguinal Endometriosis. Arch Gynecol Obstet. 2005;271(1):76-8. doi:10.1007/s00404-004-0624-z - Pubmed
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7. Fedele L, Bianchi S, Frontino G, Zanconato G, Rubino T. Radical Excision of Inguinal Endometriosis. Obstet Gynecol. 2007;110(2 Pt 2):530-3. doi:10.1097/01.AOG.0000268803.84556.0b - Pubmed
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8. Miranda L, Settembre A, Capasso P, Piccolboni D, De Rosa N, Corcione F. Inguinal Endometriosis or Irreducible Hernia? A Difficult Preoperative Diagnosis. Hernia. 2001;5(1):47-9. doi:10.1007/BF01576166 - Pubmed
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9. Yang D, Kim H, Ryu J, Lim J, Kim G. Sonographic Findings of Inguinal Endometriosis. J Ultrasound Med. 2010;29(1):105-10. doi:10.7863/jum.2010.29.1.105 - Pubmed
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