Left isolated inguinal endometriosis without pelvic endometriosis associated with PCOS and review of literature

Abstract

The coexistence of polycystic ovary syndrome (PCOS) and endometriosis is rare. Inguinal endometriosis (IEM) is an uncommon extrapelvic form of endometriosis, accounting for approximately 0.3-0.6% of all cases. It typically presents as inguinal swelling with cyclical pain and enlargement related to the menstrual cycle. A 40-year-old woman with a known diagnosis of type 1 PCOS and a history of two cesarean sections presented with a painful mass in the left inguinal region. The pain and swelling were cyclical in nature and became more pronounced during menstruation. The patient reported that her symptoms had worsened following the discontinuation of combined oral contraceptives, which she had been using for PCOS management. Physical examination revealed a tender mass in the left groin. Ultrasonography and magnetic resonance imaging demonstrated a lesion in the left inguinal region suggestive of endometriosis. Based on clinical and radiological findings, surgical intervention was planned. The patient underwent laparotomy, during which the left round ligament and the associated mass were completely excised. Intraoperative findings were consistent with endometriosis. The postoperative course was uneventful. Histopathological examination of the excised tissue confirmed the diagnosis of endometriosis. PCOS can be associated with inguinal endometriosis even without pelvic endometriosis.

Keywords

• Endometriosis
• PCOS
• canal of Nuck
• inguinal
• oral contraceptive

Pelvik endometriozisin eşlik etmediği PKOS ile birliktelik gösteren sol inguinal endometriosis

Abstract

Özet İnguinal endometriozisin prevalansı %0,3-06 oranlarında çok nadir görülen ekstrapelvik endometriozisdir. Ektopik endometrial doku hormon duyarlı olduğu için ekstpelvik endometriozis vakalarında lezyonun olduğu bölgede menstruasyon döneminde ağrı ve şişlik ortaya çıkmaktadır. Her ay bu durumun tekrar etmesi lezyon bölgesinde artmış enflamasyon, fibrozis ve ağrı ile sonuçlanmaktadır. PKOS ve inguinal endometriozis birlikteliği çok nadir görülmektedir. Vaka sunumu İki sezaryen öyküsü olan 40 yaşında kadın hasta, adet dönemleriyle çakışan tekrarlayan sol taraflı kasık ağrısı ve kitle öyküsüyle başvurdu. Rotterdam kriterlerine göre hastaya önceki takiplerinde tip 1 PKOS tanısı konmuştu. PKOS nedeniyle uzun yıllardır kombine oral kontraseptif (KOK) kullanıyordu. KOK kullanımını bıraktıktan sonra kasık ağrısı ve sol kasıkta mons pubis yakınında adet dönemlerinde artan ve diğer zamanlarda devam eden elle hissedilen bir kitleden şikayetçi oldu. Tanı, daha sonra yapılan abdominopelvik manyetik rezonans görüntüleme (MRG) incelemesiyle doğrulandı. MRG sol kasık bölgesinde endometriotik kitle tespit edildi ve sol round ligamanın ve ilişkili kasık kitlesinin laparotomik rezeksiyonu gerçekleştirildi. Ameliyat sırasındaki bulgular endometriozis ile uyumluydu. Ameliyat öncesi görüntüleme yararlıdır, ancak kesin tanı ancak cerrahi eksizyon ve histopatolojiden sonra doğrulanabilir. Sonuç: Üreme çağındaki kadınlarda İEM ve PKOS birlikte görülebilir, ancak bu durumçok nadirdir. Adet kanamasıyla ilişkili ağrılı kitleleri olan üreme çağındaki kadınlarda inguinal endometriozis düşünülmelidir.

Keywords

• Endometriozis
• PKOS
• Nuck kanal
• İnguinal

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