Abstract
Endometriosis is a common benign gynecological condition defined as the presence of endometrial tissue in tissues outside the uterine cavity. Apart from the common sites of endometriosis, rare sites other have also been reported including the liver, the thoracic cavity, the muscles, nerves, and more rarely in a patent Nuck canal. We aim to evaluate the clinical presentation, diagnostic features, and management of the Nuck endometriosis. A meticulous search of three electronic databases was performed until May 2020 for articles reporting cases of Nuck endometriosis. A total of 36 patients from 20 studies were analyzed. Median age of patients was 36 years with 33 women being of reproductive age. A right-sided lesion was identified in 30 cases (83.3%), while all patients suffer from a groin mass with cyclic pain in a proportion of 22%. All the patients finally underwent surgery for investigation of the lesion and fixation of the defect. Five cases of malignancy were detected at final pathology. All of them were alive with a median reported overall survival of 37 months. Nuck endometriosis should be included in the differential diagnosis of female patients with groin swelling. An evaluation by a gynecologist is important when endometriosis is suspected.
Highlights
Endometriosis is a common benign gynecological condition, which is characterized as the presence of endometrial tissue, containing glands and stroma, in tissues outside the uterine cavity [1]
No separate outcomes were identified in the study by Jimenez et al for the one case of NC pathology among the cases of inguinal endometriosis that were reported and was excluded [20]
Despite the fact that the study by Mazzeo et al reported a case of vulvar endometriosis in a patient with previous surgery for Nuck pathology trying to investigate the contribution NC in the pathogenesis of the disease, no endometriosis in the canal was identified and the study was excluded [21]
Summary
Endometriosis is a common benign gynecological condition, which is characterized as the presence of endometrial tissue, containing glands and stroma, in tissues outside the uterine cavity [1]. Endometriosis can be asymptomatic, in many cases, it presents with pelvic pain, infertility, or incidentally at histological examination of an ovarian cyst [2]. Due to the close relationship of endometriosis with estrogen secretion, postmenopausal women are rarely affected [3]. The diagnosis of endometriosis can be suspected by evaluation of cyclic pain and symptoms and can be enhanced with imaging findings [4]. The role of ultrasonography has gained significant popularity as diagnostic tool in the detection of pelvic endometriosis as well of less common extragenital lesions [4]
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