Heterotopic Endometriosis in the Inguinal Region

A Case Report and Literature Review

Tae Nagama, MD; Natsuko Kakudo, MD, PhD; Michika Fukui, MD; Takashi Yamauchi, MD; Toshihito Mitsui, MD; Kenji Kusumoto, MD, PhD

Disclosures

ePlasty. 2019;19(ic19) 

In This Article

Description

A 41-year-old woman presented with a slow-growing subcutaneous tumor for 10 years in the right inguinal region. Her previous surgical history was right inguinal hernia 14 years ago.

A physical examination revealed an elastic, hard, and immobile 4 × 3.5-cm tumor. Superficial pain developed on and around the tumor site (Figure 1a). Magnetic resonance imaging (MRI) showed low signal intensity on T1- (Figure 1b) and T2-weighted images.

Figure 1.

(a) Preoperative findings. A 41-year-old woman with an elastic, hard, and immobile 4 × 3.5-mm mass on the right part of the mons pubis. She had superficial pain on and around the tumor site. (b) Signal intensity of the tumor in the right inguinal region on magnetic resonance images. In this T1-weighted image, the tumor shows low signal intensity.

During surgery, the tumor was pedunculated in the medial direction, penetrated the external oblique fascia, and adhered to the round ligament of the uterus. The external oblique fascia was removed. The tumor was carefully dissected and excised between the tumor and transition part of the round ligament (Figure 2). A histopathological examination with hematoxylin-eosin staining confirmed hyperplasia of the endometrial glands, associated with stroma cells (Figure 3), which was diagnosed as endometriosis.

Figure 2.

Operative findings. We carefully dissected the tumor and excised between the tumor and transition part of the round ligament of the uterus.

Figure 3.

Histological findings of the excised tumor. Hematoxylin-eosin staining shows hyperplasia of the endometrial glands, associated with stroma cells (original magnification ×100).

There has been no pain or tumor recurrence 5 years after surgery.

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